目的 评估基于FSE的3D-动脉自 旋标记(3D-ASL)在神经胶质瘤术前分级 中的应用价值。方法 选择35例疑似脑胶 质瘤的患者为研究对象，术前均行MR常 规、3D-ASL及MR脑灌注-动态磁敏感对比 成像(DSC)。分别测得DSC和3D-ASL两种 方法中的肿瘤实质部分最大相对血流量 (rTBFmax)。将这两种方法得到的rTBFmax 做差异分析(t检验)；用两独立样本秩和 检验分别比较ASL及DSC产生的rTBFmax在 不同级别胶质瘤之间有无统计学差异。 结果 35例患者中病理证实的脑胶质瘤患 者高级别胶质瘤18例(WHO Ⅳ级11例，Ⅲ 级7例),低级别胶质瘤13例(WHO Ⅱ级)。 rTBFmax值在3D-ASL和DSC两种技术之间 的差异无明显统计学意义(P>0.05)。 3D-ASL法测得的rTBF max值，高、低 级别胶质瘤分别为(2.34±1.21)、 (0.69±0.36)，DSC法测得的rTBFmax值分 别为(2.55±1.06)、(0.72±0.52)，差 异均有统计学意义(P<0.01)。结论 3DASL可成为胶质瘤血流动力学的常规评估 方法,将其与常规MRI扫描联合用于术前 胶质瘤级别的评估会提高脑胶质瘤分级 诊断的准确性。

Objective To retrospectively assess the efficacy of 3D arterial spin labeling (3DASL) based on fast spin echo (FSE) technique in the preoperative grading of glioma. Methods Thirty-five patients who were suspected with glioma clinically underwent conventional MR imaging, 3D-ASL, and dynamic susceptibility contrast (DSC) imaging. The DSC and 3D ASL -derived index relative maximal tumor blood flow (rTBFmax) were generated from the tumors. Student t test was used to compare rTBFmax between 3D-ASL and DSC. Wilcoxon rank sum test was used to compare 3D-ASL and DSC-MRI indices for differences between low- and high- grade gliomas. Results The histological diagnosis of excised tumor from the 35 patients included in this study demonstrated that 18 patients had high-grade gliomas (11 had WHO grade IV, 7had WHO III), and 13 had low-grade gliomas ( Had WHO II). On Student t test, there was no significant difference between 3D-ASL and DSC -derived rTBFmax (P>0.05). There were significant differences between high- and low- grade glioma rTBFmax (P<0.01) for the two methods of 3D-ASL and DSC in high- and low- grade gliomas were respectively (2.34±1.21), (0.69±0.36), (2.55±1.06) and (0.72±0.52). Conclusion 3D-ASL can be utilized as a routine technique for evaluating the hemodynamics of gliomas. The combination of 3DASL and conventional MR imaging may improve the accuracy of preoperative grading in glioma.