本文選題：急性胰腺炎　切入點：彌散加權(quán)成像　出處：《川北醫(yī)學院》2017年碩士論文

【摘要】：目的:探討單指數(shù)模型、基于體素內(nèi)不相干運動(intravoxel incoherent motion,IVIM)理論的雙指數(shù)模型和基于水通道蛋白(aquaporin,AQP)的拉伸指數(shù)模型(stretched exponential model)彌散加權(quán)成像對急性胰腺炎(acute pancreatitis,AP)的診斷及臨床嚴重程度分型方面的價值。方法:前瞻性按納入標準收集本院2016年8月~2017年2月53名臨床確診為急性胰腺炎患者(AP)及20名健康志愿者(NP)進行上腹部常規(guī)MRI和14個b值(0、25、50、75、100、150、200、400、600、800、1000、1200、1500、2000s/mm2)的DWI檢查,通過Balthazar分級標準評價急性胰腺炎MRSI,分出輕癥、中重癥、重癥AP三型,測量并比較DWI單指數(shù)模型參數(shù)Standard ADC,雙指數(shù)模型參數(shù)slow ADC mono、fast ADC mono、Ff ADC mono、slow ADC Bi、fast ADC Bi、Ff ADC Bi,和拉伸指數(shù)模型參數(shù)DDC(擴散分布指數(shù))、α(水分子擴散異質(zhì)性指數(shù))在AP診斷及臨床嚴重程度分型方面的價值。結(jié)果:獨立樣本t檢驗顯示,AP組與NP組DWI單指數(shù)模型參數(shù)standard ADC、雙指數(shù)模型參數(shù)Ff ADC mono、拉伸指數(shù)模型參數(shù)DDC和α有統(tǒng)計學差異(p值分別為0.003、0.009、0.000、0.000),slow ADC mono、fast ADC mono、slow ADC Bi、fast ADC Bi、Ff ADC Bi值無統(tǒng)計學差異(p值分別為0.658、0.582、0.494、0.483、0.975)。ROC曲線顯示,standard ADC、Ff ADC mono、DDC、α值A(chǔ)UC分別為0.758、0.697、0.744、0.806,敏感性分別為81.1%、64.2%、81.1%、79.2%,特異性分別為65.0%、75.0%、60.0%、75.0%。配對比較顯示,standard ADC與FfADC mono、standard ADC與DDC、standard ADC與α、Ff ADC mono與DDC、Ff ADC mono與α、DDC與α間診斷效能無統(tǒng)計學差異(p值分別為0.235、0.728、0.590、0.212、0.237、0.488)。單因素方差分析顯示,輕癥、中重癥、重癥AP的standard ADC、Ff ADC mono、DDC、α值有統(tǒng)計學差異(p值分別為0.002、0.007、0.000、0.017)。LSD兩兩比較顯示,對區(qū)分輕癥與重癥AP參數(shù)standard ADC、Ff ADC mono、DDC、α有統(tǒng)計學差異(p值分別為0.001、0.002、0.002、0.013);對區(qū)分輕癥與中重癥AP參數(shù)Ff ADC mono、α有統(tǒng)計學差異(p值分別為0.028、0.026),參數(shù)standard ADC、DDC無統(tǒng)計學差異(p值分別為0.074、0.059);對區(qū)分中重癥與重癥AP參數(shù)standard ADC、Ff ADC mono、DDC有統(tǒng)計學差異(p值分別為0.012、0.000、0.046),參數(shù)α無統(tǒng)計學差異(p值為0.253)。結(jié)論:單指數(shù)模型參數(shù)standard ADC、雙指數(shù)模型參數(shù)Ff ADC mono、拉伸指數(shù)模型參數(shù)DDC和α可用于急性胰腺炎的診斷,并有助于急性胰腺炎臨床嚴重程度的分型。
[Abstract]:Objective: to explore a single exponential model,The value of dual exponential model based on intravoxel incoherent motion1 and aquaporin aquaporin aquaporin aqua aqua (aquaporin aqua) extension index model (DWI) diffusion weighted imaging in the diagnosis and clinical severity of acute pancreatitis (AP).Methods: from August 2016 to February 2017, 53 clinically diagnosed patients with acute pancreatitis and 20 healthy volunteers were prospectively collected according to the inclusion criteria to perform DWI examination of routine epigastric MRI and 14 b values of 2550,75100200400400800,10002001200,1500 / 2000s / m2).According to Balthazar grading criteria, acute pancreatitis was classified into mild, moderate and severe AP types.The parameters of DWI single exponential model Standard, slow ADC fast ADC fast ADC F F ADC slow ADC fast ADC ADC F f ADC, and extension index model parameters DDC (Diffusion Distribution Index, 偽) were measured and compared in the diagnosis and clinical practice of AP.The value of severity classification.Results: t test of independent samples showed that there were significant differences in standard, F _ f ADC, DDC and 偽 between AP group and NP group. The values of DDC and 偽 were 0.003 ~ 0.009 ~ 0.000 and 0.000 ~ 0.000 ~ 0.000 ~ 0.000 ~ 0.000 ~ 0.000 ~ 0.000 ~ 0.000 ~ 0.000 ~ 0.000 ~ (-1) ~ (-1) ~ (-1) ~ (-1) ~ (-1) ~ (-1) ~ (-1) ~ (-1) ~ (-1) ~ (-1) ~ (-1) ~ (-1), respectively.Pairwise comparison showed that there was no significant difference in diagnostic efficacy between standard ADC and monochromatic ADC and DDCF ADC mono and DDCF ADC mono and 偽 -DDC and 偽 -DDC, respectively. The diagnostic efficacy of standard ADC and FfADC monochromatic ADC and DDCF ADC mono were 0.235 鹵0.7280.590 and 0.2120.2370.488respectively.Univariate analysis of variance showed that there were significant differences in standard ADCF F ADC ADC DDCA between mild, moderate and severe AP, and the 偽 values were 0.002 ~ 0.007 ~ 0.000 ~ 0.000 ~ 0.017 ~ (?) L ~ (SD), respectively.There were significant differences in the parameters of standard ADCF F ADC monoDDC between the severe and the severe AP, the values of P were 0.012 ~ 0.000 ~ 0.046, and there was no significant difference in parameter 偽 between the two groups (P = 0.253).Conclusion: single exponential model parameter standard, double exponential model parameter F f ADC mono, stretching index model parameter DDC and 偽 can be used in the diagnosis of acute pancreatitis, and it is helpful for clinical classification of acute pancreatitis.
【學位授予單位】：川北醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R445.2;R576

【參考文獻】

相關(guān)期刊論文 前6條

1 陳天佑;強金偉;李若坤;蔡宋琪;;體素內(nèi)不相干運動擴散加權(quán)成像(IVIM-DWI)定量研究育齡期女性正常子宮月經(jīng)周期內(nèi)微循環(huán)變化[J];放射學實踐;2016年12期

2 孫美玉;劉愛連;李燁;陳麗華;宋清偉;徐斌;;體素內(nèi)不相干運動對前列腺癌和前列腺增生結(jié)節(jié)的鑒別診斷[J];放射學實踐;2016年10期

3 丁玖樂;邢偉;陳杰;戴勇鳴;孫軍;李登發(fā);;信噪比在腎透明細胞癌多b值DWI分析中的重要性研究[J];中華醫(yī)學雜志;2014年03期

4 Jin-Gang Hao;Jia-Ping Wang;Ya-Lv Gu;Ming-Liang Lu;;Importance of b value in diffusion weighted imaging for the diagnosis of pancreatic cancer[J];World Journal of Gastroenterology;2013年39期

5 郭啟勇;辛軍;張新;于兵;趙周社;李宏利;李紅;王曉明;廖偉;;MRI水擴散加權(quán)成像分子機理研究進展[J];中國臨床醫(yī)學影像雜志;2013年07期

6 潘華山;張小明;;急性胰腺炎的MRI評價[J];國際醫(yī)學放射學雜志;2010年01期

，

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