高场磁共振三维准连续动脉自旋标记序列对头颈部肿瘤非对比剂增强灌注成像

发布时间：2018-03-05 02:33

本文选题：动脉自旋标记　切入点：图像质量　出处：《中国医学科学院学报》2015年05期 　论文类型：期刊论文

【摘要】：目的研究高场磁共振三维准连续动脉自旋标记(3D p CASL)序列对头颈部肿瘤非对比剂增强灌注成像的可行性,分析不同标记时间(PLD)对图像质量的影响及肿瘤血流量重复测量的信度。方法前瞻性分析2013年6月至9月在北京协和医院临床发现头颈部肿瘤但未经过治疗的患者25例,所有患者均行头颈部3D p CASL非对比剂增强灌注扫描。在进行常规T1加权及T2加权成像后,进行3组不同标记后延迟(PLD)时间的ASL序列扫描:ASL1(PLD1=1525 ms)、ASL2(PLD2=2025 ms)和ASL3(PLD3=2525 ms)。测量3组ASL灌注加权图像上肿瘤区域及背景的信号强度(SI),计算肿瘤区域的信噪比(SNR)及对比噪声比(CNR)。由两位观察者分别对3D p CASL的灌注加权图像上螺旋伪影及颈部血管伪影的显示情况进行评分,测量血流量(BF)图像上肿瘤区域的BF值。结果共对17例取得病理结果的患者进行3D p CASL的图像质量评价及肿瘤的BF值测量。ASL1、ASL2及ASL3的SNR及CNR均依次降低,其中ASL1与ASL3的SNR(P=0.011)及CNR(P=0.009)差异有统计学意义。3组ASL螺旋伪影评分差异无统计学意义(P=0.932)。ASL1、ASL2及ASL3灌注加权图像颈部血管伪影的定性评分均值依次减低,其中ASL1与ASL3的差异有统计学意义(P=0.000)。3组BF值的观察者间及观察者内重复测量的信度水平均非常好(ICC0.9)。尽管ASL1、ASL2及ASL3序列的BF均值依次升高,但差异无统计学意义(P=0.977)。结论采用3D p CASL高场磁共振进行头颈部肿瘤非对比剂增强灌注成像可以获得比较满意的图像质量,并且肿瘤BF值具有较好的重复测量信度。在3组3D p CASL序列中,PLD=1525 ms及PLD=2025 ms序列的图像质量优于PLD=2525 ms序列,且BF值无明显差异,因此更适合头颈部肿瘤3D p CASL灌注成像。
[Abstract]:Objective to study the feasibility of high field magnetic resonance three-dimensional quasi-continuous arterial spin-labeled 3D pCASLs for non-contrast enhanced perfusion imaging of head and neck tumors. To analyze the effect of PLD on image quality and the reliability of repeated measurement of tumor blood flow. Methods from June 2013 to September, 25 patients with head and neck tumors who were clinically found in Peking Union Hospital without treatment were analyzed prospectively. All patients underwent 3D p CASL non-contrast enhanced perfusion scanning. After routine T 1 weighted and T 2 weighted imaging, Three groups of ASL sequences with different labeling delay time were performed to scan the tumor area and background on three groups of ASL perfusion weighted images by using ASL sequence: ASL1 / PLD1 1525 Ms / ASL2P2PLD22 / 2025 Ms). The signal to noise ratio (SNR) of the tumor area and the contrast noise ratio (CNR) were calculated. The two observers scored the spiral artifacts and the cervical vessel artifacts on 3D p CASL perfusion weighted images. Results the image quality of 3D p CASL was evaluated in 17 patients with pathological results, and the BF value of tumor. ASL1, ASL2, SNR and CNR of ASL3 were decreased in turn. There was no significant difference in ASL spiral artifact score between ASL1 and ASL3. ASL1 ASL2 and ASL3 perfusion weighted images, the qualitative score of cervical vascular artifact decreased in turn, and there was no significant difference in ASL spiral artifact score between ASL group and ASL3 group (P < 0. 01), and there was no significant difference in ASL spiral artifact score between ASL group and ASL3 group (P 0. 932). ASL 1 + ASL 2 and ASL3 perfusion weighted images decreased in turn. The difference between ASL1 and ASL3 was statistically significant. The reliability of repeated measurements of BF between observers and within observers was very good, although the mean BF of ASL1 / ASL2 and ASL3 sequences increased in turn. Conclusion 3D p CASL high field magnetic resonance imaging with non-contrast medium enhanced perfusion imaging of head and neck tumors can obtain satisfactory image quality. In the 3 groups of 3D p CASL sequences, the image quality of PLDX 1525ms and PLD=2025 Ms sequences is better than that of PLD=2525 Ms sequence, and the BF value has no obvious difference, so it is more suitable for 3D p CASL perfusion imaging of head and neck tumors.
【作者单位】：中国医学科学院北京协和医学院北京协和医院放射科;GE医疗集团MR应用科学实验室;中国医学科学院北京协和医学院北京协和医院肿瘤化疗科;中国医学科学院北京协和医学院北京协和医院口腔科;中国医学科学院北京协和医学院北京协和医院耳鼻喉科;中国医学科学院北京协和医学院北京协和医院放疗科;
【基金】：卫生公益性行业科研专项项目(201402019)~~
【分类号】：R445.2

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