D ASL腦灌注成像技術臨床應用及研究進展ppt課件

1、.,1,3D ASL腦灌注成像技術臨床應用與研究進展,301醫(yī)院放射科 婁 昕 2014年4月 11日鄭州,.,2,提綱,3D ASL研究進展,.,3,腦灌注成像研究方法,采用可彌散的示蹤劑進行成像的方法 15O-Water PET Xenon CT ASL MRI 99Tc-HMPAO SPECT（Microsphere-like tracers） 采用不可彌散的示蹤劑進行成像的方法 CTP DSC MRI,.,4,采用可彌散的示蹤劑進行成像的方法 15O-Water PET 放射性損傷、成本高 Xenon CT 放射性損傷、舒適性差 ASL MRI 99Tc-HMPAO SPECT（Mic

2、rosphere-like tracers）放射性損傷、半定量 采用不可彌散的示蹤劑進行成像的方法 CTP DSC MRI,腦灌注成像研究方法,.,5,ASL成像技術,Pulsed ASL (PASL) 脈沖式 Continuous ASL (CASL) 連續(xù)式 Pseudo-continuous ASL (PCASL) 準連續(xù)式,.,6,傳統(tǒng)ASL與3D ASL對比,傳統(tǒng)ASL,采用EPI采集，磁敏感偽影明顯 2D采集，成像范圍有限 對運動偽影敏感,采用FSE采集，有效克服磁敏感偽影 3D采集，大范圍成像 Spiral采集高效快速，有效克服運動偽影,圖像信噪比明顯提高,圖像質量不穩(wěn)定,.,7

3、,提綱,3D ASL臨床應用,.,8,3D ASL臨床應用-腫瘤鑒別,301病例,.,9,3D ASL臨床應用-腫瘤分級,301病例,.,10,3D ASL臨床應用-腫瘤分級,50歲，男性，腦干占位病變，平掃T2與T1加權像,301病例,.,11,3D ASL臨床應用-腫瘤分級,CBF=109,CBF=49,DSC灌注,3D ASL,.,12,51歲，男性，右頂葉占位病變術后，T2WI與DWI,3D ASL臨床應用-術后評估,301病例,.,13,術后增強,3D ASL臨床應用-術后評估,DSC灌注,.,14,DSC灌注,3D ASL,3D ASL臨床應用-術后評估,.,15,3D ASL臨床

4、應用-梗死后再灌注,49歲男性，右側肢體力弱,301病例,.,16,3D ASL顯示溶栓治療后過度灌注,3D ASL臨床應用-梗死后再灌注,.,17,3D ASL臨床應用-MELAS與腦梗死鑒別,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,.,18,提綱,.,19,N=8 healthy volunteers

5、(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研究進展-可重復性研究,.,20,Wu B

6、, 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研究進展-可重復性研究,.,21,Huang DD, Wu B, Shi KN, Ma L Lou X*. Reliability of Three-dimensional pseudo-c

7、ontinuous 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研究進展-可重復性研究,.,22,3D ASL研究進展-標記時間研究,.,23,3D ASL研究進展-標記時間研究,PLD=1.5S,PLD=2.5S,301病例,.,24,Lou X, Ma L. Can 3

8、D pCASL be another predictor to evaluate the collateral Perfusion in Patients with severe intracranial arterial stenosis? ISMRM Scientific Meeting, Italy, 2014,3D ASL研究進展-側枝循環(huán)成像,301病例,.,25,Hernandez D a, etc. Pseudocontinuous arterial spin labeling quantifies relative cerebral blood flow in acute st

9、roke. 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 stro

10、ke. Stroke. 2012;43:12904.,3D ASL研究進展- ASL與DSC的比較,有很好的一致性 CBF的側值無明顯差異 ASL 更有利于顯示治療后的過度灌注 (luxury perfusion),.,26,Musiek ES, etc. Direct comparison of fluorodeoxyglucose positron emission tomography and arterial spin labeling magnetic resonance imaging in Alzheimers disease. Alzheimers Dement. 2012;8

11、:51-9.,3D ASL研究進展- ASL與FDG的比較,.,27,3D ASL研究進展- 在AD中的應用,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,.,28,腦發(fā)育過程中全腦CBF的變化 腦發(fā)育過程中扣帶回和枕葉的變化,3D ASL研究進展-在腦發(fā)育中的應用,.,29,小結,ASL技術進行腦灌注成像準確無創(chuàng) 在ASL技術中PCASL序列SNR高，SAR較低 PCA