Lüdemann Lutz, Warmuth Carsten, Plotkin Michail, Förschler Annette, Gutberlet Matthias, Wust Peter, Amthauer Holger
Department of Radiation Medicine, Universitätsklinikum Charité, Campus Virchow-Klinikum, Berlin, Germany.
Eur J Radiol. 2009 Jun;70(3):465-74. doi: 10.1016/j.ejrad.2008.02.012. Epub 2008 Mar 24.
Different techniques for measuring of perfusion are clinically available, but these are usually applied to healthy brain tissue.
Five different techniques were used here in 12 patients with brain tumors to investigate the impact of tumor vascularization on the perfusion signal: three qualitative dynamic contrast-enhanced/susceptibility-contrast magnetic resonance imaging (DCE-MRI/DSC-MRI) techniques exploiting T(1), T(2), T(2)(*) contrast, and two quantitative techniques, pulsed arterial spin labeling (PASL) and H(2)(15)O positron emission tomography (H(2)(15)O-PET).
In a first approximation, a linear correlation was found between all five imaging modalities regarding the perfusion signal of both, normal brain tissue and tumor. The estimated values for tumor perfusion differed significantly between the techniques (1=methodical mean in arbitrary units): PASL: 0.83, H(2)(15)O-PET: 0.62, T(1)-DCE: 1.73, T(2)-DCE: 0.69, T(2)(*)-DSC: 0.89.
The tumor perfusion values, determined with different techniques are not comparable. The T(2)(*)-DSC, here applied with contrast agent presaturation of extravascular space, and PASL depict median perfusion most reliably.
临床上有多种测量灌注的技术，但这些技术通常应用于健康脑组织。
本研究对12例脑肿瘤患者使用了五种不同技术，以研究肿瘤血管生成对灌注信号的影响：三种利用T(1)、T(2)、T(2)(*)对比的定性动态对比增强/磁敏感对比磁共振成像（DCE-MRI/DSC-MRI）技术，以及两种定量技术，即脉冲动脉自旋标记（PASL）和H(2)(15)O正电子发射断层扫描（H(2)(15)O-PET）。
初步估计，所有五种成像方式在正常脑组织和肿瘤的灌注信号方面均存在线性相关性。不同技术测得的肿瘤灌注估计值差异显著（1 = 以任意单位表示的方法均值）：PASL：0.83，H(2)(15)O-PET：0.62，T(1)-DCE：1.73，T(2)-DCE：0.69，T(2)(*)-DSC：0.89。
用不同技术测定的肿瘤灌注值不可比。本文采用血管外间隙造影剂预饱和的T(2)(*)-DSC和PASL能最可靠地描绘中位灌注。
