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

ABSTRACT

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 used1,1 000,2 000 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.