Soni Neetu, Dhanota Devender Pal S, Kumar Sunil, Jaiswal Awadhesh K, Srivastava Arun K
Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Radiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Neurol India. 2017 Sep-Oct;65(5):1046-1052. doi: 10.4103/neuroindia.NI_871_16.
Arterial spin labeling (ASL) magnetic resonance (MR) perfusion is a noninvasive and repeatable method for quantitatively measuring cerebral blood flow (CBF). This study aims to compare measurements of ASL-derived CBF with dynamic susceptibility contrast (DSC) MRI in the assessment of enhancing brain tumors (primary and metastatic), with an aim to use ASL as an alternative to DSC.
Thirty patients with newly diagnosed brain tumors (16 meningiomas, 6 gliomas, 3 metastases, 2 cerebellopontine angle schwannoma, 1 central neurocytoma, and 2 low-grade gliomas) were examined using a 3T MR scanner. Values of CBF, regional cerebral blood flow (rCBF), and regional cerebral blood volume (rCBV) were determined in the tumor (T) as well as in the contralateral normal gray matter (GM) and white matter (WM). Tumor-to-GM or WM CBF, rCBF, and rCBV ratios were calculated to estimate normalized perfusion values (i.e., ASL normalized tumor blood flow [nTBF], DSC nTBF, and DSC normalized tumor blood volume [nTBV]) from the ASL and DSC techniques. ASL and DSC MRI derived perfusion parameters were compared using paired t-test and correlated using Pearson correlation coefficient.
Mean values for ASL nTBF and DSC nTBF using contralateral GM as the reference point were 2.98 ± 1.67and 2.91 ± 1.43, respectively. A very strong correlation coefficient was found between ASL nTBF and DSC nTBF with contralateral GM as the reference region (r = 0.903; R2= 0.813). Mean DSC nTBF and DSC nTBV also showed strong correlation (r = 0.83; R2= 0.701).
Our study results suggested that measurement of CBF from ASL possesses the potential for a noninvasive assessment of blood flow in intracranial tumors as an alternate to DSC MRI, in those patients requiring multiple follow-up imaging and in patients with impaired renal functions.
动脉自旋标记（ASL）磁共振（MR）灌注是一种用于定量测量脑血流量（CBF）的无创且可重复的方法。本研究旨在比较ASL衍生的CBF测量值与动态磁敏感对比（DSC）MRI在评估强化脑肿瘤（原发性和转移性）中的应用，目的是将ASL用作DSC的替代方法。
使用3T MR扫描仪对30例新诊断的脑肿瘤患者（16例脑膜瘤、6例胶质瘤、3例转移瘤、2例桥小脑角神经鞘瘤、1例中枢神经细胞瘤和2例低级别胶质瘤）进行检查。在肿瘤（T）以及对侧正常灰质（GM）和白质（WM）中测定CBF、局部脑血流量（rCBF）和局部脑血容量（rCBV）值。计算肿瘤与GM或WM的CBF、rCBF和rCBV比值，以从ASL和DSC技术估算标准化灌注值（即ASL标准化肿瘤血流量[nTBF]、DSC nTBF和DSC标准化肿瘤血容量[nTBV]）。使用配对t检验比较ASL和DSC MRI衍生的灌注参数，并使用Pearson相关系数进行相关性分析。
以对侧GM为参考点时，ASL nTBF和DSC nTBF的平均值分别为2.98±1.67和2.91±1.43。以对侧GM为参考区域时，ASL nTBF和DSC nTBF之间发现非常强的相关系数（r = 0.903；R2 = 0.813）。平均DSC nTBF和DSC nTBV也显示出强相关性（r = 0.83；R2 = 0.701）。
我们的研究结果表明，对于需要多次随访成像的患者以及肾功能受损的患者，ASL测量CBF具有作为DSC MRI的替代方法对颅内肿瘤血流进行无创评估的潜力。
