动脉自旋标记灌注成像技术在脑胶质瘤术前评估中的应用

摘要

目的 探讨动脉自旋标记(ASL)灌注成像技术在脑胶质瘤中的临床应用价值.方法 使用3.OT MR 成像系统对23例脑胶质瘤患者(术后病理证实高级别胶质瘤14例,低级别胶质瘤9例)术前行常规扫描外,加扫ASL灌注检查,分析不同级别胶质瘤MR灌注表现,测量肿瘤实质部分最大肿瘤血流量(TBFmax)以及对侧白质、灰质、半球的血流量(CBF).结果 在AsL灌注图像中,高级别胶质瘤呈明显的高血流灌注,低级别胶质瘤呈低血流灌注.高、低级胶质瘤TBFmax/对侧白质CBF的比值分别为6.32±2.79、3.00±1.66(P<0.01);TBFmax/对侧灰质CBF的比值分别为1.25±0.66、0.65±0.45(P<0.05);TBFmax/对侧半球CBF的比值分别为4.10±1.92、1.86±1.57(P<0.01).结论 ASL可用于评估脑胶质瘤的微血管灌注,有助于术前对脑胶质瘤进行分级评判.%Objective To investigate the clinical value of arterial spin labeling(ASL) technique for preoperatively evaluating microvascular perfusion of gliomas. Methods Twenty-three patients with gliomas(with histological diagnosis of high-grade gliomas in 14 cases and low-grade gliomas in 9 cases) were routimely examined by 3.0T MRI including ASL before operation. The maximal tumor blood flow (TBFmax) and the cerebral blood flow(CBF) of opposite white matter, grey matter and hemisphere were measured on maps. Results On the ASL maps, high grade glioma showed a higher microvascular perfusion and low grade glioma showed a lower microvascular perfusion. The ratios of TBFmax to CBF of opposite white matter were 6. 32± 2. 79 for high grade and 3. 00± 1.66 for low grade(P＜0. 01) ,which of opposite grey matter were 1.25±0.66 and 0. 65±0. 45(P＜0. 05) and of opposite hemisphere were 4.10±1.92 and 1.86±1.57(P＜0.01), respectively. Conclusion ASL may be a suitable method for the evaluation of microvascular perfusion, and is helpful in grading gliomas.