摘要目的：对比三维动脉自旋标记（3D-ASL）和动态磁敏感对比-灌注加权成像（DSC-PWI）评估烟雾病患者脑血流动力学状态的价值。方法2012年4月至2015年7月收集我院临床经DSA证实的26例成年烟雾病患者，在3.0 T MR成像设备上依次进行3D-ASL及DSC-PWI序列扫描。在DSC-达峰时间（TTP）图像上灌注异常最显著的层面选取ROI，测量灌注异常区域及对照区域ASL的脑血流量（CBF），DSC-PWI的CBF、脑血容量（CBV）、平均通过时间（MTT）、TTP参数；同时测量该层面的灌注异常区域的面积。采用配对t检验比较灌注异常区域和对照区域的ASL-CBF及DSC-PWI各灌注参数的差异。进一步计算灌注异常区域/对照区域的相对值，包括ASL-相对脑血流量（rCBF）、DSC-rCBF、DSC-相对脑血容量（rCBV）、DSC-相对平均通过时间（rMTT）、DSC-相对达峰时间（rTTP），并采用Pearson相关检验分析上述各参数之间的相关性。对ASL-CBF和DSC-TTP测得灌注减低区域的面积进行配对t检验。结果26例患者灌注异常区域ASL-CBF、DSC-MTT、DSC-TTP参数值分别为（28.18±10.19）ml·100 g-1·min-1、（7.98±2.22）s、（29.93±3.95）s，对照区域分别为（49.50±11.37）ml·100 g-1· min-1、（6.07±1.11）s、（27.34±2.58）s，两个部位间差异具有统计学意义（t值为-12.818、4.193、6.163，P值均<0.01）。标准化后的ASL-rCBF（0.56±0.14）与DSC-rMTT（1.34±0.42）、DSC-rTTP（1.09±0.69）呈负相关（r值分别为-0.630、-0.748，P值均<0.05）。DSC-TTP[（5729.63±4563.79）mm2]与ASL-CBF [（5875.33±4723.08）mm2]的灌注减低区域面积差异无统计学意义（t=-1.774，P>0.05）。结论3D-ASL灌注成像在评估烟雾病脑的低灌注区域范围和ASL-CBF的减低幅度上与DSC-TTP成像的低灌注区域范围和TTP值的升高幅度一致，并且具有无需注射钆对比剂的优点。

abstractsObjective To compare three dimensional arterial spin labeling(3D-ASL) and dynamic susceptibility contrast-perfusion weighted imaging(DSC-PWI) in evaluating the cerebral hemodynamic of Moyamoya disease. Methods Approved by the institutional review board, 26 cases of Moyamoya patients who were diagnosed by DSA were enrolled. Diffusion weighted image, 3D-TOF-MRA, 3D-ASL, DSC-WPI, and T1WI were performed in 3.0 T MR scanner. ROI were positioned in the abnormal perfusion areas and the control area according to the arterial dominant territory to obtain quantitative parameters of perfusion. Perfusion parameters including cerebral blood flow(CBF) of ASL, cerebral blood flow(CBF), cerebral blood volume(CBV), mean transit time(MTT), and time to peak(TTP)of DSC-PWI , and relative parameters (ASL-rCBF, DSC-rCBF, DSC-rCBV, DSC-rMTT, DSC-rTTP) that the ratio of abnormal perfusion area and the control area were calculated. Meanwhile, the areas of the lower perfusion region of ASL and TTP images&nbsp;in the same slice were measured. Difference of the above-mentioned parameters and areas was processed by paired Student′ t test. Furthermore, correlation of relative values of perfusion parameters(ASL-rCBF, DSC-rCBF, DSC-rCBV, DSC-rMTT, and DSC-rTTP) was processed by Pearson correlation test. Results There were significant statistics differences between values of ASL-CBF, DSC-MTT, and DSC-TTP in abnormal perfusion [(28.18 ± 10.19)ml · 100 g-1 · min-1,(7.98 ± 2.22)s,(29.93 ± 3.95)s] and the control areas [(49.50 ± 11.37)ml · 100 g-1 · min-1,(6.07 ± 1.11)s,(27.34 ± 2.58)s] (t=-12.818, 4.193, 6.163, all P<0.01). There was no significant statistics difference in the lower perfusion area between ASL-CBF [(5 729.63 ± 4 563.79) mm2]and DSC-TTP[(5 875.33 ± 4 723.08)mm2](t=-1.774,P>0.05). Furthermore, the Pearson correlation test showed significant linear dependence between ASL-rCBF(0.56±0.14)and DSC-rMTT(1.34± 0.42), and DSC-rTTP(1.09 ± 0.69)(r=-0.630,-0.748, P<0.01). Conclusions There is a correlation between 3D-ASL and DSC-PWI in assessing the magnitude and areas of the reduction of blood perfusion of Moyamoya patients. Moreover, the ASL technique possesses advantages of non-invasion use of the gadolinium contrast.