Abstract

To explore the value of three-dimensional arterial spin labeling brain perfusion imaging in the preoperative diagnosis and grading of glioma. A total of 128 patients with preoperative and postoperative intracranial occupying lesions and glioma between January 2018 and December 2020, including 76 preoperative patients and 52 postoperative patients. Routine magnetic resonance imaging and three-dimensional arterial spin labeling perfusion examinations were performed in all patients, and the cerebral blood flow values and the area size of the lesions were measured preoperatively and postoperatively, and the ratio of the two was calculated to standardize the regional cerebral blood flow. The perfusion of three-dimensional arterial spin labeling in glioma was characterized by high perfusion in solid areas of high-grade glioma and low perfusion in solid areas of low-grade glioma. The correct diagnostic rate of perfusion grading in threedimensional arterial spin labeling was found to be 93.21 %, while the accuracy rate of magnetic resonance imaging was only 84.33 %, using pathological diagnostic results as the standard. The difference between the two was statistically significant (p<0.05). The results showed that the tumor cerebral blood flow was high in the high-grade glioma group compared with the low-grade glioma group (p<0.05). The difference between the two was statistically significant (p<0.05). Regional cerebral blood flow values were statistically significant (p<0.05) between high-grade and low-grade gliomas. Receiver operating characteristic curve analysis showed that at preoperative diagnosis, regional cerebral blood flow=2.157. The sensitivity and specificity were 94.8 % and 93.2 %, respectively; while in postoperative diagnosis, the optimal diagnostic threshold for regional cerebral blood flow value to predict postoperative glioma recurrence was 3.27, with a sensitivity and specificity of 65.78 % and 90.31 %, respectively. The difference in lesion area between cerebral blood flow perfusion images of low-grade gliomas and those measured by conventional enhanced magnetic resonance imaging was statistically significant (p<0.05). The difference between cerebral blood flow perfusion images of high-grade gliomas and the lesion area measured by conventional enhanced magnetic resonance imaging was not statistically significant (p>0.05). In the diagnosis of postoperative recurrence, the cerebral blood flow values of lesions in the glioma recurrence group were significantly higher than those in the glioma non-recurrence group. The regional cerebral blood flow values of lesions in the glioma recurrence group were significantly higher than those in the glioma non-recurrence group, and the differences between the two groups were statistically different (p<0.05). Three-dimensional arterial spin labeling can provide a more comprehensive and accurate assessment of glioma, which provides a new theoretical basis for preoperative grading of glioma, prediction of postoperative recurrence and assessment of surgical planning.