Objective: To investigate the perfusion characteristics of arterial spin labeling (ASL) in intracranial tumor and its application value in classification. Methods: 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 t test between the tumor area and the contralateral mirror area were measured by the two methods. Results: 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 (P<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 (P>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. Conclusion: 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.
目的： 探讨动脉自旋标记磁共振成像(ASL)在脑肿瘤诊断中的应用价值。 方法： 回顾性分析中山大学附属肿瘤医院2015年9月至2016年6月经手术病理证实的44例脑肿瘤患者的临床、病理及影像学资料，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。均行常规磁共振平扫、ASL及动态增强扫描(DSC－MRI)，应用感兴趣区(ROI)方法获得肿瘤实体部分，评价最大脑血流量。对24例脑胶质瘤患者行免疫组化检测。比较44例颅内肿瘤患者脑血流图(CBF)与相对脑血流图(rCBF)的差异，两种方法测量肿瘤区域与对侧镜像区配对t检验。 结果： 在以对侧正常灰质(GM)为参照进行肿瘤CBF标准化时，ASL获得的三个标准化血流量(nTBF)在高级别和低级别胶质瘤间差异有统计学意义(均P<0.05)。以镜像区域(M)、对侧白质(WM)为参照进行肿瘤CBF标准化时，余各组差异均无统计学意义(均P>0.05)。在低级别胶质瘤ASL高灌注病例中未见1p缺失；在高级别胶质瘤1p缺失病例中，ASL为低灌注，ASL高灌注病例中未见1p缺失。 结论： 3D ASL可以很好的鉴别高级别与低级别胶质瘤，在颅内肿瘤定性诊断及胶质瘤术前分级有重要的参考价值。单独运用也存在低估和高估情况，需要综合分析。.
Keywords: Arterial spin-labeling magnetic resonance; Brain neoplasms; Magnetic resonance imaging.