Application of combination 3D arterial spin labeling and diffusion kurtosis imaging in the grading of gliomas / 实用放射学杂志

Objective To evaluate the diagnostic value of combining 3D arterial spin labeling (3D ASL)and DKI in grading cerebral gliomas. Methods Thirty-four patients with pathologically confirmed gliomas were enrolled in this study.3D ASL and DKI (3 b-values were used:1,1 000,2 000 s/mm2and 15 diffusion directions)were acquired and tumor blood flow (TBF),mean kurtosis(MK),mean diffusivity (MD) and fractional anisotropy of kurtosis (FAk)were measured in the solid part of the tumor.The contralateral normal appearing white matter was used to normalize these parameters.The parameters of 3D ASL and DKI before and after normalization of high-grade and low-grade gliomas were compared.Receiver operating characteristic (ROC)curve analyses were also conducted for all parameters to determine the sensitivity and specificity for grading.Results TBF and MK values were significantly higher in the high-grade gliomas than the low-grade gliomas (All P<0.001),but there were no differences of MD and FAkbetween the two groups.The area under curve (AUC)of combination TBF and MK for glioma grading was 0.951.After normalization,the AUC of combination TBF and MK was 0.986 with a sensitivity of 94.7% and specificity of 94.3%.Conclusion The multi-parameter combined analysis of 3D ASL and DKI further improves the sensitivity and specificity of preoperative glioma grading.

The advantage of 3D arterial spin labeling in the diagnosis of transient ischemic attack / 实用放射学杂志

Objective To explore the value of magnetic resonance perfusion imaging of 3D arterial spin labeling(3D-ASL)in the diagnosis of transient ischemic attack(TIA).Methods 78 of patients were diagnosed TIA on MR routine scan [T1 WI,T2 WI,T2-FLAIR,diffusion weighted imaging(DWI)],magnetic resonance angiography(MRA)and 3D arterial spin labeling(3D-ASL).The re-sult were analyzed by Chi-square test.Results In 78 patients,the abnormal routine scan was 0 case(0%);abnormal MRA 41 cases (52.6%);abnormal 3D-ASL 47 cases(60.2%);combination with each other were 60 cases(76.9%).29 cases with artery stenosis and abnormal ASL,12 case with artery stenosis and normal ASL,19 cases with normal vascular and abnormal ASL,18 cases with normal vascular and normal ASL.Conclusion 3D-ASL is better than routine magnetic resonance sequences in the diagnosis of TIA,which is convenient and should be a routine scanning sequence of TIA.3D-ASL,MRA and DWI have their own advantages and disadvantages, combination use can improve the diagnosis accuracy of TIA.

Correlation of 3D ASL perfusion index with the expression of VEGF and MVD in glioma / 中国肿瘤临床

Objective:To investigate the correlation of the relative cerebral blood flow (rCBF) of three dimensional arterial spin labeling (3D ASL) with vascular endothelial growth factor (VEGF) expression and microvessel density (MVD) in glioma. Methods:Fifty-three glio-ma patients confirmed by pathology were subjected to conventional, enhanced MR and 3D ASL imaging before operation to deter-mine VEGF expression and MVD levels in each patient. The correlations of rCBF with VEGF expression and MVD in glioma were evaluat-ed, respectively. Results:rCBF was noted to be positively correlated to VEGF expression and MVD in glioma. The rs were 0.728 (VEGF) and 0.620 (MVD), respectively (P<0.05). Conclusion:The positive correlation of rCBF with VEGF expression and MVD in glioma implied that 3D ASL is beneficial for evaluating microvessel angiogenesis in glioma prior to surgery. This finding is significant for developing clin-ical treatment plans and for assessing patient prognoses.

Preliminary study of cerebral hemodynamics evaluation by MR 3D arterial spin labeling for patients with unilateral carotid stenosis / 国际生物医学工程杂志

Objective To investigate the application value of 3D arterial spin labeling (ASL) perfusion imaging for patients with unilateral carotid stenosis or occlusion.Methods Cervical MRA and cerebral 3D ASL were performed on 36 consecutive patients with unilateral carotid stenosis diagnosed by digital subtraction angiography (DSA).The consistency of degree of stenosis between cervical MRA and DSA was analyzed.36 patients were divided into mild,moderate and severe groups by degree of stenosis,which was based on the DSA result.Variance analysis of cerebral blood flow (CBF) unilateral and contralateral changes were performed on three different groups.Patients with severe stenosis,diagnosed by DSA,were divided into symptomatic group and asymptomatic group.Analysis was carried out on unilateral and contralateral change differences between symptomatic group and asymptomatic group.Results There was no statistical significance between MRA and DSA in the cervical artery stenosis degree (kappa＞ 0.75,P＜0.05).There was no statistical difference in CBF unilateral and contralateral changes between mild group and moderate group (P＞0.01).There was statistical difference in CBF unilateral and contralateral changes between severe group and other two groups (P＜0.01).There was statistical difference in CBF unilateral and contralateral changes between symptomatic group and asymptomatic group (P＜0.01).Conclusion 3D ASL as a safe,non-invasive,repeatable method,are meaningful for cerebral hemodynamics evaluation in patients with unilateral carotid stenosis.

Preliminary study of 3D arterial spin labeling in diagnosis of ischemic cerebrovascular disease / 国际生物医学工程杂志

Objective To investigate the feasibility and clinical application value of 3D arterial spin labeling (3DASL) technique in diagnosis of ischemic cerebrovascular disease.Methods Experiment 1:Controlgroup (n=30) and brain infarction group (n=20) were established.All patients were routinely examined including 3DASL and dynamic susceptibility contrast (DSC) enhanced series.The analysis of the control group was performed using signal intensity measurement in three paired regions of interest (ROI) which were selected in left hemisphere centrum semiovale and the opposite hemisphere mirror regions respectively.The ROIs of brain infarction group were selected in the lesion areas and their mirror region.The cerebral blood flow (CBF) of each ROI was measured with 3DASL and DSC respectively.The CBF ratio to each ROI and its mirror ROI were calculated.Data were compared using paired-t test.Experiment 2:Acute cerebral infarction (n=30) and transient ischemic attack (TIA) group (n=30) were established.All patients were routinely examined including 3DASL and diffusion weighted imaging (DWI).The positive rate and the area of the lesions were calculated respectively with 3DASL and DWI and compared.Results Experiment 1:Both the control and brain infarction group demonstrated agreement between 3DASL and DSC.The CBF ratios of the control group were 1.02±0.18 and 1.06±0.24 respectively and revealed no statistically significant between that of 3DASL and DSC (P＞0.05).The CBF ratios of brain infarction group were 0.50±0.12 and 0.48±0.18 respectively,and also revealed no statistically significant between two methods (P＞0.05).Experiment 2:The positive rate of acute cerebral infarction were 100％ with both DWI and 3DASL.The areas of the lesion detected by both methods were:SDwI＜S3DASL,n=22; SDWI ≈-S3DASL,n=8; SDWI＞S3DASL,n=0.The positive rate of TIA by DWI was 0％,and 70％ by 3DASL.Conclusion The noninvasive,safe and repeatable 3DASL technique is almost as sensitive as DSC in the measurement of CBF.However,and it is more sensitive than DWI in diagnosis of TIA.Combining 3DASL and DWI will be helpful in early diagnosis of TIA,finding ischemic penumbra and estimating the blood perfusion of ischemic cerebrovascular disease.