Objectives

To examine the feasibility of performing ASL-MRI in paediatric patients with solid abdominal tumours.

Methods

Multi-delay ASL data sets were acquired in ten paediatric patients diagnosed with either a neuroblastoma (n = 4) or nephroblastoma (n = 6) during a diagnostic MRI examination at a single visit (n = 4 at initial staging, n = 2 neuroblastoma and n = 2 nephroblastoma patients; n = 6 during follow-up, n = 2 neuroblastoma and n = 4 nephroblastoma patients). Visual evaluation and region-of-interest (ROI) analyses were performed on the processed perfusion-weighted images to assess ASL perfusion signal dynamics in the whole tumour, contralateral kidney, and tumour sub-regions with/without contrast enhancement.

Results

The majority of the included abdominal tumours presented with relatively low perfusion-weighted signal (PWS), especially compared with the highly perfused kidneys. Within the tumours, regions with high PWS were observed which, at short PLD, are possibly related to labelled blood inside vessels and at long PLD, reflect labelled blood accumulating inside tumour tissue over time. Conversely, comparison of ASL perfusion-weighted image findings with T₁w enhancement after contrast administration showed that regions lacking contrast enhancement also were void of PWS.

Discussion

This pilot study demonstrates the feasibility of utilizing ASL-MRI in paediatric patients with solid abdominal tumours and provides a basis for further research on non-invasive perfusion measurements in this study population.

中文翻译：

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使用伪连续动脉自旋标记磁共振成像对儿科人群神经母细胞瘤和肾母细胞瘤的灌注成像

目标

研究在患有实体腹部肿瘤的儿科患者中进行 ASL-MRI 的可行性。

方法

 在一次诊断性 MRI 检查期间，在 10 名被诊断患有神经母细胞瘤 ( n  = 4) 或肾母细胞瘤 ( n = 6) 的儿科患者中获得了多延迟 ASL 数据集（ 初始分期时 n = 4，n =  2 神经母细胞瘤） n  = 2 名肾母细胞瘤患者；n  = 6 在随访期间，n =  2 名神经母细胞瘤和n  = 4 名肾母细胞瘤患者）。对处理后的灌注加权图像进行视觉评估和感兴趣区域 (ROI) 分析，以评估整个肿瘤、对侧肾脏和具有/不具有对比增强的肿瘤子区域中的 ASL 灌注信号动态。

结果

大多数包括的腹部肿瘤呈现相对低的灌注加权信号（PWS），特别是与高灌注的肾脏相比。在肿瘤内，观察到具有高 PWS 的区域，在短 PLD 时，可能与血管内标记的血液有关，而在长 PLD 时，反映标记的血液随着时间的推移在肿瘤组织内积聚。相反，对比给予对比剂后 ASL 灌注加权图像发现与 T ₁ w 增强的比较表明，缺乏对比增强的区域也没有 PWS。

讨论

这项初步研究证明了在患有实体腹部肿瘤的儿科患者中使用 ASL-MRI 的可行性，并为进一步研究该研究人群中的无创灌注测量提供了基础。