动脉自旋标记及体素内不相干运动成像在胶质瘤分级中的应用

摘要

目的 评价动脉自旋标记联合体素内不相干运动(intravoxel incoherent motion,IVIM)成像在胶质瘤分级中的诊断价值.材料与方法 纳入32例经病理证实的胶质瘤患者,进行3D动脉自旋标记技术(artery spin labeling,ASL)及多b值(分别为0 s/mm2、20 s/mm2、50 s/mm2、100 s/mm2、150 s/mm2、200 s/mm2、400 s/mm2、800 s/mm2、1000 s/mm2、1200 s/mm2)IVIM成像,测量所有患者脑血流量(cerebral blood flow,CBF)值及IVIM双指数模型扩散系数D值,灌注相关扩散系数D*及灌注分数f值,比较高、低级别胶质瘤的CBF及IVIM模型参数.结果 高级别胶质瘤CBF值显著高于低级别胶质瘤[分别为(75.6±12.3)ml/(100g?min)和(55.8±8.9)ml/(100g?min),P0.05]与f值(分别为11.1±6.9和7.2±4.1,P>0.05)差异无统计学意义.联合CBF及D*值对胶质瘤分级的曲线下面积(area under curve,AUC)为0.935,其敏感性和特异性分别为91.5%及89.6%.结论 通过3D ASL及IVIM多参数联合分析,进一步提高了术前肿瘤分级评估的敏感性和特异性,为临床提供一种无创的更准确的胶质瘤分级方法.%Objective: To evaluate the diagnostic value of combining 3D artery spin labeling and intravoxel incoherent motion in grading of cerebral gliomas. Materials and Methods: A total of 32 patients with histopathology proved gliomas (13 low grade, 19 high grade) were included in this study. 3D ASL and multi-b IVIM images were retrospectively analyzed. The ASL and IVIM data were processed on workstation to get the CBF and D, D*, f values. The results were compared among high grade and low grade groups and P0.05)] and f (11.1±6.9, 7.2±4.1, respectively; P>0.05). The area under AUC of combination of CBF and D* for glioma grading was 0.935 and corresponding diagnostic sensitivity and specificity were 91.5% and 89.6%. Conclusion:The combination of 3D ASL and IVIM parameters can be used to differentiate high grade glioma and low grade glioma. Combination of CBF and D* value obtain better diagnostic performance than other parameters.