3D ASL脑灌注成像技术临床应用及研究进展

1、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 4月 11日郑州1/31提要 3D ASL研究进展2/31脑灌注成像研究方法采取可弥散示踪剂进行成像方法15O-Water PETXenon CTASL MRI99Tc-HMPAO SPECT（Microsphere-like tracers）采取不可弥散示踪剂进行成像方法CTPDSC MRI3/31采取可弥散示踪剂进行成像方法15O-Water PET 放射性损伤、成本高Xenon CT 放射性损伤、舒适性差ASL MRI99Tc-HMPAO SPECT（Microsphere-like tracers）放射性损伤、半定量采

2、取不可弥散示踪剂进行成像方法CTPDSC MRI脑灌注成像研究方法4/31ASL成像技术Pulsed ASL (PASL) 脉冲式Continuous ASL (CASL) 连续式Pseudo-continuous ASL (PCASL) 准连续式SNRACCURACYSARPASL+CASL+PCASL+5/31传统ASL与3D ASL对比 3D ASL 传统ASL采取EPI采集，磁敏感伪影显著2D采集，成像范围有限对运动伪影敏感采取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 图像信噪比显著提升 图像质量不稳定6/31提要 3D ASL临床应

3、用7/313D ASL临床应用-肿瘤判别脑膜瘤海绵状血管瘤301病例8/313D ASL临床应用-肿瘤分级星形细胞瘤, WHO II 级星形细胞瘤, WHO III 级301病例9/313D 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10/313D ASL临床应用-肿瘤分级CBF=109CBF=49DSC灌注3D ASL11/31 51岁，男性，右顶叶占位病变术后，T2WI与DWI3D ASL临床应用-术后评定301病例12/31术后增强3D ASL临床应用-术后评定DSC灌注13/31CBF=85CBF=41DSC灌注3D ASL3D ASL临床应用

4、-术后评定14/313D ASL临床应用-梗死后再灌注治疗前治疗后49岁男性，右侧肢体力弱301病例15/31 3D ASL显示溶栓治疗后过分灌注3D ASL临床应用-梗死后再灌注16/313D ASL临床应用-MELAS与脑梗死判别 MELAS脑梗死Lou X, Ma L, et al. Differential Diagnosis of MELAS and Ischemic Stroke using 3D Pseudocontinuous Arterial Spin Labeling. ISMRM Scientific Meeting, Italy, 301病例17/31提要18/31N=

5、8 healthy volunteers (7M, 1F, 27-41Y)PCASL, BS, 3D spiral FSE 3 Scans on 2 scanners, 10-15 days apartPLD = 2.5SPLD = 1.5S1st test (scanner 1)2nd test (scanner 2)3rd test (scanner 1)100806040200100806040200PLD = 1.5SPLD = 2.5S100806040200PLD = 1.5SPLD = 2.5SSubject 1Subject 2Subject 3100806040200PLD

6、= 1.5SPLD = 2.5SSubject 43D ASL研究进展-可重复性研究19/31Wu 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. ;39(2):402-9.3D ASL研究进展-可重复性研究20/31Huang DD, Wu B, Shi KN, Ma L Lou

7、X*. Reliability of Three-dimensional pseudo-continuous arterial spin labelling MR imaging for measuring visual cortex perfusion on two 3T scanners. PLOS ONE. ;8(11):e79471HuangDD, Lou X*, Ma L, etc. RSNA, , Oral presentation3D ASL研究进展-可重复性研究21/313D ASL研究进展-标识时间研究22/3116.5651.0442.2943.123D ASL研究进展-标

8、识时间研究PLD=1.5SPLD=2.5S301病例23/31Lou 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, 3D ASL研究进展-侧枝循环成像301病例24/31Hernandez D a, etc. Pseudocontinuous arterial spin labeling quantifie

9、s relative cerebral blood flow in acute stroke. Stroke. ;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. ;43:101824.Bokkers RPH,etc. Whole-brain arterial spin labeling perfusio

10、n MRI in patients with acute stroke. Stroke. ;43:12904. 3D ASL研究进展- ASL与DSC比较有很好一致性CBF侧值无显著差异ASL 更有利于显示治疗后过分灌注 (luxury perfusion)25/31Musiek ES, etc. Direct comparison of fluorodeoxyglucose positron emission tomography and arterial spin labeling magnetic resonance imaging in Alzheimers disease. Alzh

11、eimers Dement. ;8:51-9.3D ASL研究进展- ASL与FDG比较26/313D ASL研究进展- 在AD中应用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 ; 267:221230.70 Subjects with Subjective Complaints 31 Patients with MCI 71 Patients with AD27/31脑发育过程中全脑CBF改变脑发育过程中扣带回和枕叶改变3D ASL研究进展-在脑发育中应用28/31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，S