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目的对比研究动态磁敏感对比增强(dynamic susceptibility contrast-enhanced,DSC)MRI及动脉自旋标记(aterial spin labeling,ASL)技术在脑肿瘤术前评估中的作用,探讨ASL技术在脑肿瘤术前评估中的应用价值。方法经病理证实的41例脑肿瘤患者,其中高级别胶质瘤8例,低级别胶质瘤16例,转移瘤7例,脑膜瘤10例。采用3.0 T MR扫描仪行ASL流动敏感交互反转恢复(flow-sensitive alternating inversion recovery,FAIR)法及DSC灌注检查,将原始图像分析处理后分别获取肿瘤实性区域、瘤周1 cm及2 cm区域血流灌注指标平均最大相对脑血流量(rCBFmax)比值。所得数据经统计学处理,P<0.05为差异有统计学意义;对两种技术所得平均rCBFmax比值行线性回归分析,得出其相关系数,了解其相关性。结果在肿瘤实性区域,两种技术所得rCBFmax低级别胶质瘤组与其他各组间差异均有统计学意义(P<0.05);在瘤旁1 cm区域,DSC技术所得rCBFmax高级别胶质瘤组与其他各组间差异均有统计学意义(P<0.05),而ASL技术rCBFmax在各组差异无统计学意义(P>0.05)。两种技术所得rCBFmax在各组脑肿瘤瘤区实性区域与瘤旁1 cm及2 cm区域差异均有统计学意义(P<0.05)。两种技术于肿瘤实性区域所得灌注指标显著正相关(r=0.907)。结论 ASL技术是一种无需注射对比剂的MR灌注方法,可考虑作为常规检查方法评估脑肿瘤血流动力学情况,指导脑肿瘤术前级别评估。
Objective To compare the role of dynamic susceptibility contrast-enhanced (DSC) MRI and aterial spin labeling (ASL) in preoperative evaluation of brain tumors and to evaluate the value of ASL in preoperative assessment of brain tumors In the application value. Methods Totally 41 cases of brain tumor confirmed by pathology, including 8 cases of high grade glioma, 16 cases of low grade glioma, 7 cases of metastasis and 10 cases of meningioma. Using 3.0 T MR scanner ASL flow-sensitive alternating inversion recovery (FAIR) method and DSC perfusion test, the original images were analyzed and processed to obtain the solid tumor area, the tumor circumference 1 cm and 2 cm Regional perfusion index mean maximum relative cerebral blood flow (rCBFmax) ratio. The data obtained by the statistical analysis, P <0.05 for the difference was statistically significant; the average rCBFmax ratio of the two techniques were linear regression analysis, the correlation coefficient was drawn to understand its relevance. Results There was a significant difference between the rCBFmax low-grade glioma group and other groups in the solid tumors (P <0.05). In the 1-cm para-tumor area, high-grade glomerular rCBFmax There was significant difference between the tumor group and other groups (P <0.05), while the rCBFmax in ASL group had no statistical significance (P> 0.05). The rCBFmax of the two techniques had statistical significance in the 1 cm and 2 cm of the tumor area in each solid brain tumor area (P <0.05). There was a significant positive correlation between perfusion parameters of the two techniques in the solid tumor area (r = 0.907). Conclusion ASL is a MR perfusion method without injection of contrast medium. It can be considered as a routine examination method to assess the hemodynamics of brain tumors and guide the preoperative assessment of brain tumors.