Zhao Q Q, Yang Q X, Xu G X, Lü Y C, Rong D L, Liu L, Zhang R
State Key Laboratory of Oncology in Southern China, Minimally Invasive and Interventional Department, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
Zhonghua Yi Xue Za Zhi. 2017 Jun 20;97(23):1801-1804. doi: 10.3760/cma.j.issn.0376-2491.2017.23.009.
To investigate the perfusion characteristics of arterial spin labeling (ASL) in intracranial tumor and its application value in classification. The clinical, pathological and imaging data of 44 patients with gliomas confirmed by pathology were analyzed retrospectively, including 9 low grade gliomas, 15 high grade gliomas, 11 cases of meningiomas, 6 cases of neurilemmoma, 3 cases of metastatic tumors.Conventional plain scan, 3D- ASL and MRI dynamic enhanced imaging (DSC-MRI) were performed.The mean maximal cerebral blood flow (CBF) of the solid component of tumor was obtained based on the region of interest.Immunohistochemical staining was performed in 24 patients with glioma.The differences of cerebral blood flow map (CBF) and relative cerebral blood flow (rCBF) in 44 patients with intracranial tumors were compared. The results of paired test between the tumor area and the contralateral mirror area were measured by the two methods. Taken the normal control-lateral grey matter(GM) as reference to normalize the CBF of tumor, three normalized tumor blood flow (nTBF) acquired by ASL showed statistical difference between low grade and high grade gliomas respectively (<0.05). While taken the mirror region (M) and normal control-lateral white matter (WM) as reference to normalize the CBF of tumor, it showed no statistical difference (>0.05). There was no 1p deletion in the cases of ASL perfusion in low-grade glioma group.In the case of 1p deletion in high grade glioma group, ASL was low perfusion, and there was no 1p deletion in the cases of ASL perfusion. 3D ASL can be used to identify high-grade and low-grade gliomas which has important reference value in the qualitative diagnosis of brain tumors and preoperative grading of gliomas.A separate use of 3D-ASL might cause over-or underestimation of tumor diagnosis, therefore a comprehensive analysis is needed.
探讨动脉自旋标记(ASL)在颅内肿瘤中的灌注特征及其在肿瘤分类中的应用价值。回顾性分析44例经病理证实的胶质瘤患者的临床、病理及影像资料,其中低级别胶质瘤9例,高级别胶质瘤15例,脑膜瘤11例,神经鞘瘤6例,转移瘤3例。均行常规平扫、三维ASL及磁共振成像动态增强扫描(DSC-MRI)。基于感兴趣区获取肿瘤实性成分的平均最大脑血流量(CBF)。对24例胶质瘤患者行免疫组化染色。比较44例颅内肿瘤患者的脑血流图(CBF)及相对脑血流量(rCBF)差异,采用两种方法测量肿瘤区域与对侧镜像区域的配对检验结果。以正常对照侧灰质(GM)为参照对肿瘤CBF进行标准化,ASL获得的3种标准化肿瘤血流量(nTBF)在低级别和高级别胶质瘤之间分别显示出统计学差异(<0.05)。而以镜像区域(M)和正常对照侧白质(WM)为参照对肿瘤CBF进行标准化时,差异无统计学意义(>0.05)。低级别胶质瘤组ASL灌注病例中无1p缺失。高级别胶质瘤组中存在1p缺失的病例,ASL表现为低灌注,ASL灌注病例中无1p缺失。三维ASL可用于鉴别高级别和低级别胶质瘤,对脑肿瘤的定性诊断及胶质瘤的术前分级具有重要参考价值。单独使用三维ASL可能会导致肿瘤诊断的高估或低估,因此需要综合分析。