Quantitative measurement of blood flow in paediatric brain tumours-a comparative study of dynamic susceptibility contrast and multi time-point arterial spin labelled MRI.
Quantitative measurement of blood flow in paediatric brain tumours-a comparative study of dynamic susceptibility contrast and multi time-point arterial spin labelled MRI.
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小儿脑肿瘤中血流的定量测量 - 对动态敏感性对比度和多个时间点动脉自旋的比较研究。
DOI：
10.1259/bjr.20150624
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发表时间：
2016-06
期刊：
影响因子：
--
通讯作者：
Parkes LM
中科院分区：
文献类型：
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作者：
Vidyasagar R;Abernethy L;Pizer B;Avula S;Parkes LM
动脉自旋标记（ASL） MRI使用固有血水来量化脑血流量（CBF），无需注射基于钆的造影剂，这种造影剂用于常规灌注成像，如动态敏感性对比（DSC）。由于该技术的非侵入性，ASL是一种有吸引力的选择，用于儿科患者。这项工作比较了DSC和多时间点ASL测量儿童脑肿瘤的CBF。23例患者（低级别肿瘤20例，高级别肿瘤3例）有DSC和多时间点ASL，伴或不伴血管粉碎剂（VC）。VC消除了大血管血流的贡献。从对照和t1增强的肿瘤感兴趣区域（roi）中提取平均灌注指标：有和没有VC的ASL图像中的动脉到达时间（AAT）和CBF， DSC图像中的相对脑血流量（rCBF），相对脑血容量，延迟时间（DT）和平均传递时间（MTT）。AAT和DT （r = 0.77, p = 0.0002）、CBF和rCBF （r = 0.56, p = 0.02）在ASL-noVC的对照roi中存在显著相关。肿瘤区域的DSC和ASL测量之间没有显著的相关性。MTT （p < 0.001）和rCBF （p < 0.005）指标在对照组和肿瘤ROI之间存在显著差异。正常脑ASL-noVC和DSC测量之间的显著相关性表明DSC对大血管血流最为敏感。肿瘤ROI内缺乏显著相关性表明，与DSC测量相比，ASL对不同生理机制敏感。ASL提供的信息与健康组织中的DSC相当，但似乎反映了肿瘤组织中的不同生理。
Arterial spin-labelling (ASL) MRI uses intrinsic blood water to quantify the cerebral blood flow (CBF), removing the need for the injection of a gadolinium-based contrast agent used for conventional perfusion imaging such as dynamic susceptibility contrast (DSC). Owing to the non-invasive nature of the technique, ASL is an attractive option for use in paediatric patients. This work compared DSC and multi-timepoint ASL measures of CBF in paediatric brain tumours. Patients (n = 23; 20 low-grade tumours and 3 high-grade tumours) had DSC and multi-timepoint ASL with and without vascular crushers (VC). VC removes the contribution from larger vessel blood flow. Mean perfusion metrics were extracted from control and T1-enhanced tumour regions of interest (ROIs): arterial arrival time (AAT) and CBF from the ASL images with and without VC, relative cerebral blood flow (rCBF), relative cerebral blood volume, delay time (DT) and mean transit time (MTT) from the DSC images. Significant correlations existed for: AAT and DT (r = 0.77, p = 0.0002) and CBF and rCBF (r = 0.56, p = 0.02) in control ROIs for ASL-noVC. No significant correlations existed between DSC and ASL measures in the tumour region. Significant differences between control and tumour ROI were found for MTT (p < 0.001) and rCBF (p < 0.005) measures. Significant correlations between ASL-noVC and DSC measures in the normal brain suggest that DSC is most sensitive to macrovascular blood flow. The absence of significant correlations within the tumour ROI suggests that ASL is sensitive to different physiological mechanisms compared with DSC measures. ASL provides information which is comparable with that of DSC in healthy tissues, but appears to reflect a different physiology in tumour tissues.