3．0TMR动脉自旋标记与动态磁敏感对比增强灌注技术在脑胶质瘤术前分级中的对照研究

目的：对照研究动脉自旋标记（arterial spin labeling，ASL）与动态磁敏感对比增强（dynamic susceptibility contrast—enhanced．DSC）灌注成像技术在脑胶质瘤中的灌注特点．探讨ASL在脑胶质瘤术前分级中的临床应用价值。方法：使用3．0TMR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17例，低级别胶质瘤6例）术前行常规扫描外，加扫ASL及DSC灌注检查。测量肿瘤实质部分最大肿瘤血流量（maximal tumor blood flow，TBFmax）以及对侧白质、对侧灰质、对侧半球的血流量（cerebral blood flow，CBF）。结果：23例脑胶质瘤患者。两种灌注方法均获得了一致的灌注结果，TBF max／对侧白质CBF、TBFmax／对侧灰质CBF及TBFmax／对侧半球CBF的各比值在ASL和DSC两种技术之间的差异无明显统计学意义（P〉0．05），但在高、低级别胶质瘤之间的差异均有统计学意义（P〈0．05）。在ASL法中，TBFmax／对侧白质CBF、TBFmax／对侧灰质CBF及TBFmax／对侧半球CBF分别取阈值为3．06、0．46和1．31时，其敏感性分别为i00％、88．2％和100％．特异性分别为83．3％、83．3％和100％。结论：ASL在评估脑胶质瘤血流灌注方面与DSC之间有相似的敏感性，具有可重复性高、完全无创性等优点，同时有助于术前对脑胶质瘤进行分级评判。

Comparison of arterial spin labeling and dynamic susceptibility contrast-enhanced MR imaging for the preoperation evaluation of tumor grade in brain gliomas

Objective:To compare the arterial spin labeling and dynamic susceptibility contrast-enhanced MR imaging and explore the clinical application of arterial spin labeling(ASL) technique in the preoperation of tumor grade in brain gliomas.Methods:Twenty-three patients with gliomas(all the cases were verified histologically,including 17 patients of high-grade gliomas,6 patients of low-grade gliomas) were routinely examined by 3.0 T MRI including ASL and DSC before operation.The maximal cerebral blood flow of soli...