3DASL脑灌注成像技术临床应用及研究进展.ppt

3D ASL脑灌注成像技术临床应用与研究进展,301医院放射科 娄 昕 2014年4月 11日郑州,提纲,3D ASL技术简介,3D ASL临床应用,3D ASL研究进展,脑灌注成像研究方法,采用可弥散的示踪剂进行成像的方法 15O-Water PET Xenon CT ASL MRI 99Tc-HMPAO SPECT（Microsphere-like tracers） 采用不可弥散的示踪剂进行成像的方法 CTP DSC MRI,采用可弥散的示踪剂进行成像的方法 15O-Water PET 放射性损伤、成本高 Xenon CT 放射性损伤、舒适性差 ASL MRI 99Tc-HMPAO SPECT（Microsphere-like tracers）放射性损伤、半定量 采用不可弥散的示踪剂进行成像的方法 CTP DSC MRI,脑灌注成像研究方法,ASL成像技术,Pulsed ASL (PASL) 脉冲式 Continuous ASL (CASL) 连续式 Pseudo-continuous ASL (PCASL) 准连续式,传统ASL与3D ASL对比,传统ASL,采用EPI采集，磁敏感伪影明显 2D采集，成像范围有限 对运动伪影敏感,采用FSE采集，有效克服磁敏感伪影 3D采集，大范围成像 Spiral采集高效快速，有效克服运动伪影,图像信噪比明显提高,图像质量不稳定,提纲,3D ASL临床应用,3D ASL临床应用-肿瘤鉴别,301病例,3D ASL临床应用-肿瘤分级,301病例,3D ASL临床应用-肿瘤分级,50岁，男性，脑干占位病变，平扫T2与T1加权像,301病例,3D ASL临床应用-肿瘤分级,CBF=109,CBF=49,DSC灌注,3D ASL,51岁，男性，右顶叶占位病变术后，T2WI与DWI,3D ASL临床应用-术后评估,301病例,术后增强,3D ASL临床应用-术后评估,DSC灌注,DSC灌注,3D ASL,3D ASL临床应用-术后评估,3D ASL临床应用-梗死后再灌注,49岁男性，右侧肢体力弱,301病例,3D ASL显示溶栓治疗后过度灌注,3D ASL临床应用-梗死后再灌注,3D ASL临床应用-MELAS与脑梗死鉴别,Lou X, Ma L, et al. Differential Diagnosis of MELAS and Ischemic Stroke using 3D Pseudocontinuous Arterial Spin Labeling. ISMRM Scientific Meeting, Italy, 2014,301病例,提纲,3D ASL研究进展,N=8 healthy volunteers (7M, 1F, 27-41Y) PCASL, BS, 3D spiral FSE 3 Scans on 2 scanners, 10-15 days apart,PLD = 2.5S,PLD = 1.5S,1st test (scanner 1),2nd test (scanner 2),3rd test (scanner 1),PLD = 1.5S,PLD = 2.5S,PLD = 1.5S,PLD = 2.5S,Subject 1,Subject 2,Subject 3,PLD = 1.5S,PLD = 2.5S,Subject 4,3D ASL研究进展-可重复性研究,Wu B, Lou X*, Wu XH, Ma L. Intra- and inter-scanner reliability and reproducibility of 3D whole-brain pseudo-continuous arterial spin-labeling MR perfusion on 3T. J Magn Reson Imaging. 2014;39(2):402-9.,3D ASL研究进展-可重复性研究,Huang DD, Wu B, Shi KN, Ma L Lou X*. Reliability of Three-dimensional pseudo-continuous arterial spin labelling MR imaging for measuring visual cortex perfusion on two 3T scanners. PLOS ONE. 2013;8(11):e79471 HuangDD, Lou X*, Ma L, etc. RSNA, 2013, Oral presentation,3D ASL研究进展-可重复性研究,3D ASL研究进展-标记时间研究,3D ASL研究进展-标记时间研究,PLD=1.5S,PLD=2.5S,301病例,Lou X, Ma L. Can 3D pCASL be another predictor to evaluate the collateral Perfusion in Patients with severe intracranial arterial stenosis? ISMRM Scientific Meeting, Italy, 2014,3D ASL研究进展-侧枝循环成像,301病例,Hernandez D a, etc. Pseudocontinuous arterial spin labeling quantifies relative cerebral blood flow in acute stroke. Stroke. 2012;43:7538. Wang DJ, etc. The value of arterial spin-labeled perfusion imaging in acute ischemic stroke: comparison with dynamic susceptibility contrast-enhanced MRI. Stroke. 2012;43:101824. Bokkers RPH,etc. Whole-brain arterial spin labeling perfusion MRI in patients with acute stroke. Stroke. 2012;43:12904.,3D ASL研究进展- ASL与DSC的比较,有很好的一致性 CBF的侧值无明显差异 ASL 更有利于显示治疗后的过度灌注 (luxury perfusion),Musiek ES, etc. Direct comparison of fluorodeoxyglucose positron emission tomography and arterial spin labeling magnetic resonance imaging in Alzheimers disease. Alzheimers Dement. 2012;8:51-9.,3D ASL研究进展- ASL与FDG的比较,3D ASL研究进展- 在AD中的应用,Maja A. A. Binnewijzend, etc. Cerebral Blood Flow Measured with 3D Pseudocontinuous Arterial Spin-labeling MR Imaging in Alzheimer Disease and Mild Cognitive Impairment: A Marker for Disease Severity. Radiology 2013; 267:221230. 70 Subjects with Subjective Complaints 31 Patients with MCI 71 Patients with AD,脑发育过程中全脑CBF的变化 脑发育过程中扣带回和枕叶的变化,3D ASL研究进展-在脑发育中的应用,小结,ASL技术进行脑灌注成像准确无创 在ASL技术中PCASL序列SNR高，SAR较