Article Figures & Data
Figures
- FIG 1.
ROIs were located in the tumor and white matter of the contralateral hemisphere, and the measurements are seen on mpASL (A) and DSC (B) perfusion maps.
- FIG 2.
Anaplastic astrocytoma in a 44-year-old female patient. There is a mass in the T2-weighted (B) sequence showing a signal increase in the right thalamus. Also, there is a slight expansion in both T2-weighted (B) and the postcontrast T1-weighted (A) sequences. There is no significant enhancement in the postcontrast T1-weighted (A) MR image. There are no significant increases in perfusion in the mass localization derived from the DSC (C) perfusion color map (DSC rrCBF = 1.1). In the mpASL perfusion map (D), the perfusion increase in the mass localization can be seen clearly (ASL rrCBF = 3.3) (arrow).
- FIG 3.
A 49-year-old male patient who underwent an operation and received chemoradiotherapy due to a glioblastoma in the temporoparietal region 1 year ago. T1-weighted (A) and T2-weighted (C) MR images show postoperative changes and alterations in the signal intensities in the right temporoparietal region. The postcontrast image (B) shows wide-scale enhancement in the site of the operation. The T2*-weighted image (D) shows hypointensities secondary to old bleeding residues (black arrow). The DSC perfusion map (E) shows a large perfusion signal loss caused by leakage artifacts in the contrasted areas (DSC rrCBF = 1.3). In the mpASL perfusion map (F), there is a significant increase in perfusion at the site of the operation (white arrows) (ASL rrCBF = 3.5). The patient was diagnosed with a recurrent glioblastoma after the second operation.
- FIG 4.
The ROC analysis curve. The blue line shows mpASL perfusion, and the green and the brown lines represent the DSC perfusion MR imaging technique for rrCBF and rrCBV, respectively.
- FIG 5.
Anaplastic astrocytoma in a 41-year-old male patient. Postcontrast T1-weighted (A) image shows a wide nonenhancing mass lesion in the right temporoparietal region. There was no diffusion restriction (not shown here). The DSC (B) and mpASL (C) maps show significantly hyperperfused areas within the mass (arrows) (DSC rrCBF = 2.3, ASL rrCBF = 4.6). The spASL (D) map shows no increases in perfusion. It is also remarkable that the signal-to-noise ratio of spASL is lower than that of mpASL.
Tables
Sequence Parameters spASL mpASL DSC Acquired orientation Axial Axial Axial TR (ms) 4000 250 1800 TE (ms) 25 20 40 Flip angle 70° 35° 75° FOV (mm2) 240 240 224 Matrix (pixel) 68 × 68 68 × 68 88 × 88 Thickness/gap (mm) 6/0.6 6/0.6 5/0 Pulse delay times (ms) 1200 300, 550, 800, 1050, 1300, 1550, 1800, 2050 – Label thickness/gap (mm) 100/20 130/20 – Acquisition time 4 min 8 sec 4 min 8 sec 1 min 40 sec Note:—–indicates “no labelling” and “no pulse delay time”; DSC, dynamic susceptibility contrast; FOV, field-of-view; mpASL, multi phase arterial spin-labeling; spASL, single phase arterial spin-labeling; TE, echo time; TR, repetition time.
No. Percentage Histopathologic diagnosis 38 44.2 Benign lesions 13 15.1 Diffuse astrocytoma 7 8.1 WHO grade II oligodendroglioma 2 2.3 DNET 2 2.3 Cerebellar astrocytoma 1 1.2 Ganglioglioma 1 1.2 Malignant lesions 25 29.1 Glioblastoma 14 16.3 Anaplastic astrocytoma 7 8.1 Anaplastic oligondendroglioma 2 2.3 Gliosarcoma 2 2.3 Follow-up diagnosis 48 55.8 Benign lesions 32 37.2 Malignant lesions 16 18.6 Total 86 100 Note:—DNET indicate dysembryoplastic neuroepithelial tumors.
- Table 3:
Perfusion parameters of benign and malignant tumors on the quantitative evaluation
Benign Tumors Mean (± SD) Malignant Tumors Mean (± SD) Pa Sensitivity (%) Specificity (%) Accuracy (%) All lesions (n = 86)b mpASL rrCBF 1.19 (0.59) 2.84 (1.44) <.001 85.4 84.4 84.9 DSC rrCBF 1.19 (0.69) 2.93 (1.57) <.001 82.9 80.0 81.45 DSC rrCBV 1.20 (0.62) 3.07 (1.43) <.001 68.3 97.8 83.05 Group 1 (n = 38)c mpASL rrCBF 1.24 (0.47) 3.06 (1.45) <.001 94.4 80.0 87.2 DSC rrCBF 1.33 (0.83) 3.13 (1.80) <.001 88.9 75.0 81.95 DSC rrCBV 1.32 (0.67) 3.22 (1.43) <.001 66.7 100 83.35 Group 2 (n = 48)d mpASL rrCBF 1.16 (0.68) 2.67 (1.45) <.001 78.3 88.0 83.15 DSC rrCBF 1.08 (0.54) 2.77 (1.39) <.001 78.3 84.0 81.15 DSC rrCBV 1.10 (0.58) 2.96 (1.45) <.001 69.6 96.0 82.8
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