Objective:

To explore the value of three-dimensional arterial spin labeling (

3D-ASL) and dynamic susceptibility contrast-enhanced (DSC)-perfusion-weighted imaging (PWI) in the differential diagnosis of postoperative recurrence and radiation necrosis of high-grade glioma (HGG).

Methods:

40 patients with HGG who underwent postoperative magnetic resonance imaging (MRI) follow-up with abnormal enhanced lesions were selected. 20 cases of postoperative recurrence and 20 cases of radiation necrosis were confirmed by the second operation pathology or long-term follow-up examination. All cases underwent routine MRI

MRI enhancement

3D-ASL

32 cases underwent DSC-PWI. The values of hemodynamic parameters related to focal reactivity and normal contralateral image were got

and the values of perfusion parameters in the differential diagnosis of postoperative recurrence and radiation necrosis of HGG were analyzed statistically.

Results:

The hemodynamic parameters of 3D-ASL-relative cerebral blood flow (ASL-rCBF)

DSC-PWI-rCBF (DSC-rCBF) and DSC-relative cerebral blood volume (DSC-rCBV) in the postoperative recurrence group of HGG were significantly higher than those in the radiation necrosis group (

P

＜0.01). ASL-rCBF has the highest diagnostic efficiency. And when ASL-rCBF=2.32 is the critical value

the diagnostic efficiency is the highest. While

there were no statistically significant differences in DSC-relative mean transit time (DSC-rMTT) and DSC-relative time to peak (DSC-rTTP)between the postoperative recurrence and the radiation necrosis (

P

=0.21

0.15).

Conclusion:

Both 3D-ASL and DSC-PWI can distinguish postoperative recurrence and radiation necrosis of HGG

and the diagnostic efficacy of ASL-rCBF was slightly higher than that of DSC-rCBF and DSC-rCBV.