醫(yī)學(xué)DASL腦灌注成像技術(shù)臨床應(yīng)用和研究進(jìn)展培訓(xùn)課件

DASL腦灌注成像技術(shù)臨床應(yīng)用和研究進(jìn)展DASL腦灌注成像技術(shù)臨床應(yīng)用和研究進(jìn)展1提綱3DASL研究進(jìn)展提綱3DASL研究進(jìn)展2腦灌注成像研究方法采用可彌散的示蹤劑進(jìn)行成像的方法15O-WaterPETXenonCTASLMRI99Tc-HMPAOSPECT（Microsphere-liketracers）采用不可彌散的示蹤劑進(jìn)行成像的方法CTPDSCMRI腦灌注成像研究方法采用可彌散的示蹤劑進(jìn)行成像的方法3采用可彌散的示蹤劑進(jìn)行成像的方法15O-WaterPET放射性損傷、成本高XenonCT放射性損傷、舒適性差A(yù)SLMRI99Tc-HMPAOSPECT（Microsphere-liketracers）放射性損傷、半定量采用不可彌散的示蹤劑進(jìn)行成像的方法CTPDSCMRI腦灌注成像研究方法采用可彌散的示蹤劑進(jìn)行成像的方法腦灌注成像研究方法4ASL成像技術(shù)PulsedASL(PASL)脈沖式ContinuousASL(CASL)連續(xù)式Pseudo-continuousASL(PCASL)準(zhǔn)連續(xù)式SNRACCURACYSARPASL+++++CASL+++++++PCASL++++++++ASL成像技術(shù)PulsedASL(PASL)脈沖式SN5傳統(tǒng)ASL與3D

ASL對比

3DASL

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(yùn)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(yùn)動偽影圖像信噪比明顯提高圖像質(zhì)量不穩(wěn)定傳統(tǒng)ASL與3DASL對比3DA6提綱3DASL臨床應(yīng)用提綱3DASL臨床應(yīng)用73D

ASL臨床應(yīng)用--腫瘤鑒別腦膜瘤海綿狀血管瘤301病例3DASL臨床應(yīng)用--腫瘤鑒別腦膜瘤海綿狀血管瘤301病例83D

ASL臨床應(yīng)用--腫瘤分級星形細(xì)胞瘤,WHOII級星形細(xì)胞瘤,WHOIII級301病例3DASL臨床應(yīng)用--腫瘤分級星形細(xì)胞瘤,WHOII93D

ASL臨床應(yīng)用--腫瘤分級

50歲，男性，腦干占位病變，平掃T2與T1加權(quán)像301病例3DASL臨床應(yīng)用--腫瘤分級50歲，男性，腦干占位病103D

ASL臨床應(yīng)用--腫瘤分級CBF=109CBF=49DSC灌注3DASL3DASL臨床應(yīng)用--腫瘤分級CBF=109CBF=49D11

51歲，男性，右頂葉占位病變術(shù)后，T2WI與DWI3D

ASL臨床應(yīng)用--術(shù)后評估301病例51歲，男性，右頂葉占位病變術(shù)后，T2WI與DWI312術(shù)后增強(qiáng)3D

ASL臨床應(yīng)用--術(shù)后評估DSC灌注術(shù)后增強(qiáng)3DASL臨床應(yīng)用--術(shù)后評估DSC灌注13CBF=85CBF=41DSC灌注3DASL3D

ASL臨床應(yīng)用--術(shù)后評估CBF=85CBF=41DSC灌注3DASL3DASL臨143D

ASL臨床應(yīng)用--梗死后再灌注治療前治療后49歲男性，右側(cè)肢體力弱301病例3DASL臨床應(yīng)用--梗死后再灌注治療前治療后49歲男性，15

3DASL顯示溶栓治療后過度灌注3D

ASL臨床應(yīng)用--梗死后再灌注3DASL顯示溶栓治療后過度灌注3DASL臨床應(yīng)用163D

ASL臨床應(yīng)用--MELAS與腦梗死鑒別

MELAS腦梗死LouX,MaL,etal.DifferentialDiagnosisofMELASandIschemicStrokeusing3DPseudocontinuousArterialSpinLabeling.ISMRMScientificMeeting,Italy,2014301病例3DASL臨床應(yīng)用--MELAS與腦梗死鑒別MELAS腦17提綱提綱18N=8healthyvolunteers(7M,1F,27-41Y)PCASL,BS,3DspiralFSE3Scanson2scanners,10-15daysapartPLD=2.5SPLD=1.5S1sttest(scanner1)2ndtest(scanner2)3rdtest(scanner1)100806040200100806040200PLD=1.5SPLD=2.5S100806040200PLD=1.5SPLD=2.5SSubject1Subject2Subject3100806040200PLD=1.5SPLD=2.5SSubject43D

ASL研究進(jìn)展--可重復(fù)性研究N=8healthyvolunteers(7M,1F19WuB,LouX*,WuXH,MaL.Intra-andinter-scannerreliabilityandreproducibilityof3Dwhole-brainpseudo-continuousarterialspin-labelingMRperfusionon3T.JMagnResonImaging.2014;39(2):402-9.3D

ASL研究進(jìn)展--可重復(fù)性研究WuB,LouX*,WuXH,MaL.Int20HuangDD,WuB,ShiKN,MaLLouX*.ReliabilityofThree-dimensionalpseudo-continuousarterialspinlabellingMRimagingformeasuringvisualcortexperfusionontwo3Tscanners.PLOSONE.2013;8(11):e79471HuangDD,LouX*,MaL,etc.RSNA,2013,Oralpresentation3D

ASL研究進(jìn)展--可重復(fù)性研究HuangDD,WuB,ShiKN,MaLL213D

ASL研究進(jìn)展--標(biāo)記時間研究3DASL研究進(jìn)展--標(biāo)記時間研究2216.5651.0442.2943.123D

ASL研究進(jìn)展--標(biāo)記時間研究PLD=1.5SPLD=2.5S301病例16.5651.0442.2943.123DASL研究進(jìn)展23LouX,MaL.Can3DpCASLbeanotherpredictortoevaluatethecollateralPerfusioninPatientswithsevereintracranialarterialstenosis?ISMRMScientificMeeting,Italy,20143D

ASL研究進(jìn)展--側(cè)枝循環(huán)成像301病例LouX,MaL.Can3DpCASLbea24HernandezDa,etc.Pseudocontinuousarterialspinlabelingquantifiesrelativecerebralbloodflowinacutestroke.Stroke.2012;43:753–8.WangDJ,etc.Thevalueofarterialspin-labeledperfusionimaginginacuteischemicstroke:comparisonwithdynamicsusceptibilitycontrast-enhancedMRI.Stroke.2012;43:1018–24.BokkersRPH,etc.Whole-brainarterialspinlabelingperfusionMRIinpatientswithacutestroke.Stroke.2012;43:1290–4.3D

ASL研究進(jìn)展--ASL與DSC的比較有很好的一致性CBF的側(cè)值無明顯差異ASL

更有利于顯示治療后的過度灌注(luxuryperfusion)HernandezDa,etc.Pseudocont25MusiekES,etc.DirectcomparisonoffluorodeoxyglucosepositronemissiontomographyandarterialspinlabelingmagneticresonanceimaginginAlzheimer'sdisease.AlzheimersDement.2012;8:51-9.3D

ASL研究進(jìn)展--ASL與FDG的比較MusiekES,etc.Directcompari263D

ASL研究進(jìn)展--

在AD中的應(yīng)用MajaA.A.Binnewijzend,etc.CerebralBloodFlowMeasuredwith3DPseudocontinuousArterialSpin-labelingMRImaginginAlzheimerDiseaseandMildCognitiveImpairment:AMarkerforDiseaseSeverity.Radiology2013;267:221–230.70SubjectswithSubjectiveComplaints31PatientswithMCI71PatientswithAD3DASL研究進(jìn)展--在AD中的應(yīng)用MajaA.A.27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(jìn)展--在腦發(fā)育中的應(yīng)用腦發(fā)育過程中全腦CBF的變化3DASL研究進(jìn)展--在腦發(fā)育28小結(jié)ASL技術(shù)進(jìn)行腦灌注成像準(zhǔn)確無創(chuàng)在ASL技術(shù)中PCASL序列SNR高，SAR較低PCASL序列的可重復(fù)性好PCASL序列掃描參數(shù)選擇中PLD是關(guān)鍵ASL臨床應(yīng)用范圍廣泛小結(jié)ASL技術(shù)進(jìn)行腦灌注成像準(zhǔn)確無創(chuàng)29本次發(fā)言中未涵蓋的內(nèi)容灌注成像在食物、藥物藥代動力學(xué)方面的應(yīng)用Stateandtrait(phenotype/genotype)effects狀態(tài)與特質(zhì)（表型與基因型）效應(yīng)對CBF的影響Perfusion-basedfMRI小結(jié)本次發(fā)言中未涵蓋的內(nèi)容灌注成像在食物、藥物藥代動力學(xué)方面的應(yīng)30謝謝！謝謝！31DASL腦灌注成像技術(shù)臨床應(yīng)用和研究進(jìn)展DASL腦灌注成像技術(shù)臨床應(yīng)用和研究進(jìn)展32提綱3DASL研究進(jìn)展提綱3DASL研究進(jìn)展33腦灌注成像研究方法采用可彌散的示蹤劑進(jìn)行成像的方法15O-WaterPETXenonCTASLMRI99Tc-HMPAOSPECT（Microsphere-liketracers）采用不可彌散的示蹤劑進(jìn)行成像的方法CTPDSCMRI腦灌注成像研究方法采用可彌散的示蹤劑進(jìn)行成像的方法34采用可彌散的示蹤劑進(jìn)行成像的方法15O-WaterPET放射性損傷、成本高XenonCT放射性損傷、舒適性差A(yù)SLMRI99Tc-HMPAOSPECT（Microsphere-liketracers）放射性損傷、半定量采用不可彌散的示蹤劑進(jìn)行成像的方法CTPDSCMRI腦灌注成像研究方法采用可彌散的示蹤劑進(jìn)行成像的方法腦灌注成像研究方法35ASL成像技術(shù)PulsedASL(PASL)脈沖式ContinuousASL(CASL)連續(xù)式Pseudo-continuousASL(PCASL)準(zhǔn)連續(xù)式SNRACCURACYSARPASL+++++CASL+++++++PCASL++++++++ASL成像技術(shù)PulsedASL(PASL)脈沖式SN36傳統(tǒng)ASL與3D

ASL對比

3DASL

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(yùn)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(yùn)動偽影圖像信噪比明顯提高圖像質(zhì)量不穩(wěn)定傳統(tǒng)ASL與3DASL對比3DA37提綱3DASL臨床應(yīng)用提綱3DASL臨床應(yīng)用383D

ASL臨床應(yīng)用--腫瘤鑒別腦膜瘤海綿狀血管瘤301病例3DASL臨床應(yīng)用--腫瘤鑒別腦膜瘤海綿狀血管瘤301病例393D

ASL臨床應(yīng)用--腫瘤分級星形細(xì)胞瘤,WHOII級星形細(xì)胞瘤,WHOIII級301病例3DASL臨床應(yīng)用--腫瘤分級星形細(xì)胞瘤,WHOII403D

ASL臨床應(yīng)用--腫瘤分級

50歲，男性，腦干占位病變，平掃T2與T1加權(quán)像301病例3DASL臨床應(yīng)用--腫瘤分級50歲，男性，腦干占位病413D

ASL臨床應(yīng)用--腫瘤分級CBF=109CBF=49DSC灌注3DASL3DASL臨床應(yīng)用--腫瘤分級CBF=109CBF=49D42

51歲，男性，右頂葉占位病變術(shù)后，T2WI與DWI3D

ASL臨床應(yīng)用--術(shù)后評估301病例51歲，男性，右頂葉占位病變術(shù)后，T2WI與DWI343術(shù)后增強(qiáng)3D

ASL臨床應(yīng)用--術(shù)后評估DSC灌注術(shù)后增強(qiáng)3DASL臨床應(yīng)用--術(shù)后評估DSC灌注44CBF=85CBF=41DSC灌注3DASL3D

ASL臨床應(yīng)用--術(shù)后評估CBF=85CBF=41DSC灌注3DASL3DASL臨453D

ASL臨床應(yīng)用--梗死后再灌注治療前治療后49歲男性，右側(cè)肢體力弱301病例3DASL臨床應(yīng)用--梗死后再灌注治療前治療后49歲男性，46

3DASL顯示溶栓治療后過度灌注3D

ASL臨床應(yīng)用--梗死后再灌注3DASL顯示溶栓治療后過度灌注3DASL臨床應(yīng)用473D

ASL臨床應(yīng)用--MELAS與腦梗死鑒別

MELAS腦梗死LouX,MaL,etal.DifferentialDiagnosisofMELASandIschemicStrokeusing3DPseudocontinuousArterialSpinLabeling.ISMRMScientificMeeting,Italy,2014301病例3DASL臨床應(yīng)用--MELAS與腦梗死鑒別MELAS腦48提綱提綱49N=8healthyvolunteers(7M,1F,27-41Y)PCASL,BS,3DspiralFSE3Scanson2scanners,10-15daysapartPLD=2.5SPLD=1.5S1sttest(scanner1)2ndtest(scanner2)3rdtest(scanner1)100806040200100806040200PLD=1.5SPLD=2.5S100806040200PLD=1.5SPLD=2.5SSubject1Subject2Subject3100806040200PLD=1.5SPLD=2.5SSubject43D

ASL研究進(jìn)展--可重復(fù)性研究N=8healthyvolunteers(7M,1F50WuB,LouX*,WuXH,MaL.Intra-andinter-scannerreliabilityandreproducibilityof3Dwhole-brainpseudo-continuousarterialspin-labelingMRperfusionon3T.JMagnResonImaging.2014;39(2):402-9.3D

ASL研究進(jìn)展--可重復(fù)性研究WuB,LouX*,WuXH,MaL.Int51HuangDD,WuB,ShiKN,MaLLouX*.ReliabilityofThree-dimensionalpseudo-continuousarterialspinlabellingMRimagingformeasuringvisualcortexperfusionontwo3Tscanners.PLOSONE.2013;8(11):e79471HuangDD,LouX*,MaL,etc.RSNA,2013,Oralpresentation3D

ASL研究進(jìn)展--可重復(fù)性研究HuangDD,WuB,ShiKN,MaLL523D

ASL研究進(jìn)展--標(biāo)記時間研究3DASL研究進(jìn)展--標(biāo)記時間研究5316.5651.0442.2943.123D

ASL研究進(jìn)展--標(biāo)記時間研究PLD=1.5SPLD=2.5S301病例16.5651.0442.2943.123DASL研究進(jìn)展54LouX,MaL.Can3DpCASLbeanotherpredictortoevaluatethecollateralPerfusioninPatientswithsevereintracranialarterialstenosis?ISMRMScientificMeeting,Italy,20143D

ASL研究進(jìn)展--側(cè)枝循環(huán)成像301病例LouX,MaL.Can3DpCASLbea55HernandezDa,etc.Pseudocontinuousarterialspinlabelingquantifiesrelativecerebralbloodflowinacutestroke.Stroke.2012;43:753–8.WangDJ,etc.Thevalueofarterialspin-labeledperfusionimaginginacuteischemicstroke:comparisonwithdynamicsusceptibilitycontrast-enhancedMRI.Stroke.2012;43:1018–24.BokkersRPH,etc.Whole-brainarterialspinlabelingperfusionMRIinpatientswithacutestroke.Stroke.2012;43:1290–4.3D

ASL研究進(jìn)展--ASL與DSC的比較有很好的一致性CBF的側(cè)值無明顯差異ASL

更有利于顯示治療后的過度灌注(luxuryperfusion)HernandezDa,etc.Pseudocont56MusiekES,etc.Directcomparisonoffluoro