Évaluation du degré de malignité des tumeurs gliales primitives de l’adulte en IRM de perfusion par marquage des spins

SummaryPurposeWe investigated the relationship between tumor blood-flow measurement based on perfusion-imaging by arterial spin-labeling (ASL) and histopathologic findings in adults’ primitive glial tumours.Patients and methodsThus, 40 primitive brain tumors (8 low-grade and 32 high-grade gliomas according to the Sainte-Anne classification) were imaged using pulsed (n = 19) or continuous (n = 21) ASL. Relative cerebral blood flow (rCBF = tumoral blood flow/normal cerebral blood flow) between high- and low-grade gliomas were compared.ResultsUsing pulsed ASL, differences in mean rCBF were observed in high- and low-grade gliomas although no significant (respectively 1.95 and 1.5). Using continuous ASL, mean rCBF were significantly higher for high-grade than for low-grade gliomas (P < 0.05). High-grade gliomas could be discriminated using a CBF threshold of 1.18, with a sensitivity of 88%, specificity of 60%, predictive positive value of 88%, and predictive negative value of 60%.ConclusionASL-based perfusion provides a quantitative, non-invasive alternative to dynamic susceptibility contrast perfusion MR methods for evaluating CBF. ASL is a suitable method for gliomas initial staging and could be useful to identify intermediate tumoral evolution.