The Application Of Three-dimensional Arterial Spin Labeling MR Perfusion Imaging On The Grading Brain Glioma

Objective:To evaluate the diagnostic performance of three-dimensional arterial spin labeling(3D ASL) MR perfusion imaging technology in glioma quantitative analysis and imaging characterization.Methods: 1. twenty-eight cases were Collected from September 2013 to January 2015 in our hospital which initially diagnosed glioma patients, routine MRI scans and 3D ASL perfusion imaging, plus sweeping dynamic susceptibility contrast imaging.All the cases were verified histologically,including11 patients of ow-grade gliomas,17 patients of high-grade gliomas;2. Using GE Discovery 750 3.0T MR and 8-channel phased head coil;3. With Functool software in the AW4.6 workstation, measuring the resulting 3D ASL and DSC perfusion parameter map,the maximal cerebral blood flow of solid regions of tumor(TBFmax) and the cerebral blood flow of opposite hemisphere matter, opposite grey matter and opposite white were measured on maps. Using paired samples t test,taking α=0.05 significance level for statistical analysis to P<0.05 was considered statistically significant,3D ASL and DSC for both technologies in glioma surgery before income average maximum relative cerebral blood flow(r CBFmax) the ratio of the line of linear regression analysis, to understand its relevance.Draw the receiver operating characteristic curve(receiver operating characteristic curve, ROC curve), low-grade gliomas to determine the optimal classification threshold and calculating the sensitivity, specificity and accuracy. Finally, paired comparison Chi-square test conventional MRI sequences and 3D ASL perfusion imaging techniques combined diagnosis of gliomas and grading consistent rate.Results: 1. 28 cases of glioma patients,3D ASL and DSC two technologies resulting in low perfusion index, were statistically significant(P<0.05), but the comparison between the two techniques of high-grade gliomas,the difference was not statistically significant(P>0.05), the two techniques of solid tumor perfusion index area TBFmax/contra lateral hemisphere,TBFmax/contra lateral gray matter,TBFmax/contra lateral white matter ratio for each line of linear regression analysis showed a significant positive correlation, the correlation coefficient respectively : r=0.953, r=0.892, r=0.781;2. 3D ASL perfusion imaging perfusion index TBFmax/contralateral hemisphere in solid tumor area, TBFmax/contra lateral gray matter, each ratio TBFmax/contra lateral white matter in distinguishing high glioma,the area under the ROC curve between low levels(AUC),respectively to 0.969,0.956,0.896;which when in TBFmax/contralateral hemisphere the largest ratio(0.969),with TBFmax/contralateral hemisphere ratio> 2.11 for diagnostic threshold,low high-grade gliomas diagnostic sensitivity,specificity,positive predictive value, and negative predictive values were 100%, 91.7%, 94.1% and 100 %;3.DSC perfusion imaging in tumor perfusion index solid areas TBFmax/contra lateral hemisphere,TBFmax/contra lateral gray matter,each ratio TBFmax/contra lateral white matter in distinguishing high glioma,the area under the ROC curve between low levels(AUC),respectively 0.948,0.943,0.904;which when in TBFmax/contralateral hemisphere the largest area ratio(0.948),with TBFmax/contralateral hemisphere ratio>1.91 for the diagnostic threshold,low high-grade gliomas diagnostic sensitivity,specificity, positive predictive value, and negative predictive value were 100%,83.3%, 88.9% and 100%;4. Combined with the pathological diagnosis, the diagnosis rate for conventional plan was 82.1%, whereas 89.2% while combing 3D ASL diagnosis, with no statistically significant difference(P >0.05), but scanning in3 D ASL to some extent, improve the rate of coincidence of diagnosis.Conclusion: 3D ASL and DSC measurement glioma solid areas rCBF values were well correlated,3D ASL perfusion imaging has high repeatability, completely non-invasive,etc. where the solid tumor area TBFmax /contralateral hemisphere ratio possible to distinguish high and low-grade glioma is the most sensitive parameter.3D ASL can quantitatively react tumor microcirculation perfusion with conventional MRI sequences in combination, can be used as an important supplement for brain tumor diagnosis and before surgery grade gliomas have important reference value.