ASL脑灌注成像技术临床应用及研究进展ppt课件

1 3D ASL研究进展 2 p 采用 可弥散的示踪剂进行成像的方法 p 15O-Water PET p Xenon CT p ASL MRI p 99Tc-HMPAO SPECT（ Microsphere-like tracers） p 采用不 可弥散的示踪剂进行成像的方法 p CTP p DSC MRI 3 p 采用 可弥散的示踪剂进行成像的方法 p 15O-Water PET 放射性 损伤 、成本高 p Xenon CT 放射性 损伤 、舒适性差 p ASL MRI p 99Tc-HMPAO SPECT（ Microsphere-like tracers） 放射性 损伤 、半定量 p 采用不 可弥散的示踪剂进行成像的方法 p CTP p DSC MRI 4 p Pulsed ASL (PASL) 脉冲式 p Continuous ASL (CASL) 连续 式 p Pseudo-continuous ASL (PCASL) 准 连续 式 SNR ACCURACY SAR PASL + + + CASL + + + PCASL + + + 5 3D ASL 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 6 3D ASL临床应用 7 脑膜瘤 海绵状血管瘤 301病例 8 星形细胞瘤 , WHO II 级 星形细胞瘤 , WHO III 级 301病例 9 50岁，男性，脑干占位病变，平扫岁，男性，脑干占位病变，平扫 T2与与 T1加权像加权像 301病例 10 CBF=109 CBF=49 DSC灌注灌注 3D ASL 11 51岁，男性，右顶叶占位病变术后，岁，男性，右顶叶占位病变术后， T2WI与与 DWI 301病例 12 术后增强术后增强 DSC灌注灌注 13 CBF=85 CBF=41 DSC灌注灌注 3D ASL 14 治疗前治疗前 治疗后治疗后 49岁男性，右侧肢体力弱岁男性，右侧肢体力弱 301病例 15 3D ASL显示溶栓治疗后过度灌注显示溶栓治疗后过度灌注 16 MELAS 脑脑 梗死梗死 Lou X, Ma L, et al. Differential Diagnosis of MELAS and Ischemic Stroke using 3D Pseudocontinuous Arterial Spin Labeling. ISMRM Scientific Meeting, Italy, 2014 301病例 17 18 p N=8 healthy volunteers (7M, 1F, 27-41Y) p PCASL, BS, 3D spiral FSE p 3 Scans on 2 scanners, 10-15 days apart PLD = 2.5SPLD = 1.5S 1st test (scanner 1) 2nd test (scanner 2) 3rd test (scanner 1) 100 80 60 40 20 0 100 80 60 40 20 0 PLD = 1.5S PLD = 2.5S 100 80 60 40 20 0 PLD = 1.5S PLD = 2.5S Subject 1 Subject 2 Subject 3 100 80 60 40 20 0 PLD = 1.5S PLD = 2.5S Subject 4 19 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. 20 uHuang 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 uHuangDD, Lou X*, Ma L, etc. RSNA, 2013, Oral presentation 21 22 16.56 51.04 42.29 43.12 PLD=1.5S PLD=2.5S 301病例 23 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 301病例 24 u Hernandez D a, etc. Pseudocontinuous arterial spin labeling quantifies relative cerebral blood flow in acute stroke. Stroke. 2012;43:7538. u 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. u Bokkers RPH,etc. Whole-brain arterial spin labeling perfusion MRI in patients with acute stroke. Stroke. 2012;43:12904. p 有很好的一致性 p CBF的 侧值 无明 显 差异 p ASL 更有利于 显 示治 疗 后的 过 度灌注 (luxury perfusion) 25 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. 26 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 . p 70 Subjects with Subjective Complaints p 31 Patients with MCI p 71 Patients with AD 27 p 脑发 育 过 程中全 脑 CBF的 变 化 p 脑发 育 过 程中扣 带 回和枕叶的 变 化 28 pASL技 术进 行 脑 灌注成像准确无 创 p在 ASL技 术 中 PCASL序列 SNR高， SAR较 低 pPCASL序列的可重复性好 pPCAS