3D pseudo-continuous arterial spin labeling-MRI (3D PCASL-MRI) in the differential diagnosis between glioblastomas and primary central nervous system lymphomas
3D pseudo-continuous arterial spin labeling-MRI (3D PCASL-MRI) in the differential diagnosis between glioblastomas and primary central nervous system lymphomas
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DOI：
10.1007/s00234-021-02888-4
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发表时间：
2022-02-03
期刊：
影响因子：
2.8
通讯作者：
Pronin, I. N.
中科院分区：
文献类型：
--
作者：
Batalov, A., I;Afandiev, R. M.;Pronin, I. N.
目的比较伪连续动脉自旋标记磁共振成像(3D PCASL)测量的胶质母细胞瘤和原发性中枢神经系统淋巴瘤(PCNSLs)的血流参数，并探讨其在鉴别诊断中的信息性。在核磁共振之前，没有患者接受过化疗、激素治疗或放射治疗。结果胶质母细胞瘤组的平均血流速度为168.9 ml/100g/min，平均血流速度为65.6g/min，平均血流速度为9.3ml/100g/min，明显高于正常对照组的3.7ml/100g/min(p<；0.001)。动脉自旋标记灌注对PCNSL和胶质母细胞瘤的鉴别诊断具有较高的敏感性(max TBF均值86%，nTBF均值95%)和特异性(max TBF均值77%，nTBF 73%)。以绝对血流值计算的血流阈值为98.9ml/100g/min，以归一化值AUC>；0.88计算的血流阈值为6.1。结论将3DPCASL纳入标准MRI方案可提高胶质母细胞瘤与PCNSL鉴别诊断的特异性。
Purpose The aim of the study was to compare the parameters of blood flow in glioblastomas and primary central nervous system lymphomas (PCNSLs), measured by pseudo-continuous arterial spin labeling MRI (3D PCASL), and to determine the informativeness of this method in the differential diagnosis between these lesions.Methods The study included MRI data of 139 patients with PCNSL (n = 21) and glioblastomas (n = 118), performed in the Burdenko Neurosurgical Center. No patients received chemotherapy, hormone therapy, or radiation therapy prior to MRI. On the 3D PCASL perfusion map, the absolute and normalized values of tumor blood flow were calculated in the glioblastoma and PCNSL groups (maxTBFmean and nTBF).Results MaxTBFmean and nTBF in the glioblastoma group were significantly higher than those in the PCNSL group: 168.9 ml/100 g/min versus 65.6 and 9.3 versus 3.7, respectively (p < 0.001). Arterial spin labeling perfusion had high sensitivity (86% for maxTBFmean, 95% for nTBF) and specificity (77% for maxTBFmean, 73% for nTBF) in the differential diagnosis between PCNSL and glioblastomas. Blood flow thresholds were 98.9 ml/100 g/min using absolute blood flow values and 6.1 using normalized values, AUC > 0.88.Conclusion The inclusion of 3D PCASL in the standard MRI protocol can increase the specificity of the differential diagnosis between glioblastomas and PCNSL.