目的: 探讨应用多反转时间动脉自旋标记(multiple inversion time-pulsed arterial spin labeling,mTI-ASL)和体素内不相干运动(intravoxel incoherent motion,IVIM)技术在脑胶质瘤术后复发与假性进展中的鉴别价值。方法: 选择2018年01月至2020年01月就诊于我院高级别胶质瘤术后放化疗后首次复查常规MR增强扫描出现异常强化的患者,行mTI-ASL及IVIM序列扫描,将获取图像数据资料进行相关后处理分析,分别手动勾画感兴趣区,测量术后异常强化区各项定量参数,即真性扩散系数(true diffusion coefficient,D)、假性扩散系数(pseudo-diffusion coefficient,D*)及灌注分数(perfusion fraction,f)、脑血流量(cerebral blood flow,CBF)和动脉通过时间(arterial transit time,ATT)。分别采用独立样本t检验比较两组感兴趣区相关参数值,从而评估mTI-ASL和IVIM技术在两者鉴别诊断中的价值。结果: (1)脑胶质瘤术后复发组CBF值(6.413±0.438)、ATT值(0.198±0.033),比假性进展组CBF值(4.654±0.372)、ATT值(0.165±0.208)高,两者比较具有统计学意义(P＜0.01)。(2)脑胶质瘤术后复发组D值(1.118±0.178),比假性进展组D值(1.380±0.236)低,两者比较具有统计学意义(P＜0.01)。(3)脑胶质瘤术后复发组D*值(17.126±4.274)、f值(0.269±0.095),比假性进展组D*值(12.755±3.974)、f值(0.169±0.052)高,两者比较具有统计学意义(P＜0.01)。结论:应用 mTI-ASL和IVIM技术有助于脑胶质瘤术后复发与假性进展的鉴别诊断。

Objective:To investigate the value of multiple inversion time-pulled arterial spin labeling (mTI-ASL) and intravoxel incoherent motion (IVIM) in differentiating the recurrence and pseudoprogression of high-grade Gliomas after operation.Methods: mTI-ASL and IVIM sequence scans were performed in the first time after radiotherapy and chemotherapy for high-grade gliomas from January 2018 to January 2020, after the image data were acquired, the region of interest was manually delineated, and the quantitative parameters of the abnormal enhancement region were measured, they are true diffusion coefficient (D) , pseudo-diffusion coefficient (D *) , perfusion fraction (f) , cerebral blood flow (CBF) and arterial transit time (ATT). Independent sample t test was used to evaluate the value of mTI-ASL and Ivim in the differential diagnosis of glioma recurrence and false progression. Results: (1) CBF (6.413 ± 0.438) and ATT (0.198 ± 0.033) were significantly higher in the recurrent group than those in the false progression group (4.654 ± 0.372) and ATT (0.165 ± 0.208) (P＜0.01) . (2) The D value of the recurrent group (1.118 ± 0.178) was lower than that of the false progression group (1.380 ± 0.236) (P＜0.01). (3) The D*value (17.126 ± 4.274) and f value (0.269 ± 0.095) of the recurrent group were significantly higher than those of the false progression group (12.755 ± 3.974) and F value (0.169 ± 0.052) (P＜0.01).Conclusion: mTI-ASL and IVIM techniques are helpful in the differential diagnosis of postoperative recurrence and pseudoprogression of high-grade glioma after operation.

R445.2

内蒙古自治区自然科学(编号：2018MS08078)；内蒙古医科大学2019年度高等学校科学研究项目(编号：NJZY19105)；内蒙古医科大学附属医院博士启动金计划项目(编号：NYFY BS 202108)；内蒙古自治区科技计划项目(编号：2019GG047)