本文關(guān)鍵詞： 3.0TMRI DWI 雙指數(shù)衰減模型 盆腔腫瘤 鑒別診斷　出處：《大連醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：通過(guò)3.0TMRI對(duì)女性盆腔掃描，用多b值雙指數(shù)衰減模型對(duì)病變部位進(jìn)行處理，通過(guò)記錄多種參數(shù)，用多種方法進(jìn)行比較，來(lái)探討多b值雙指數(shù)衰減模型在盆腔良、惡性病變中的鑒別診斷價(jià)值。 資料與方法：對(duì)56例病人69個(gè)病灶行MR750-DWI掃描，其中良性病變35個(gè)：肌瘤12個(gè)，囊腫12個(gè)，巧克力囊腫6個(gè)，囊腺瘤3個(gè)，畸胎瘤2個(gè)；惡性病變34個(gè)：宮頸癌16個(gè)（均為鱗癌），子宮內(nèi)膜癌15個(gè)（均為腺癌），卵巢癌3個(gè)。把b值設(shè)置為0、50、300、600、800、1200s/mm2，通過(guò)AW451工作站，利用Functool-MADC軟件進(jìn)行處理，取三次測(cè)量的平均值，感興趣區(qū)（RegionOfInterest，ROI）選擇橫斷面較大、密度均勻的地方，盡量避開囊變、壞死、出血的地方，囊腺瘤測(cè)量實(shí)性部分，畸胎瘤測(cè)量脂肪成分，三次測(cè)量的感興趣區(qū)面積盡量一致（每次浮動(dòng)范圍不超過(guò)20mm2），分別記錄SlowADC值、FastADC值、StandardADC值、FractionoffastADC值，并分別進(jìn)行比較。最后，把軸位T2脂肪抑制圖像與StandardADC圖融合，能夠更好的顯示盆腔的結(jié)構(gòu)，更精確的定位腫瘤。把發(fā)病率高的子宮內(nèi)膜癌和宮頸癌分別進(jìn)行比較，以查看多b值雙指數(shù)衰減模型對(duì)惡性腫瘤病理類型鑒別的價(jià)值。 結(jié)果：良性病變的SlowADC值（1.74±0.89）×10-3mm2/s、StandardADC值（1.73±0.79）×10-3mm2/s值均大于惡性腫瘤[SlowADC值=（0.97±0.28）×10-3mm2/s、StandardADC值=（1.11±0.27）×10-3mm2/s]，良性病變與惡性病變的SlowADC值之間、StandardADC值之間的均有統(tǒng)計(jì)學(xué)意義（p均0.05），且SlowADC值在良、惡性病變間的差異較大。此外，良、惡性病變的FastADC值均大于SlowADC值，且良性病變的SlowADC值、FastADC值分別為（1.74±0.89）×10-3mm2/s、（15.94±9.01）×10-3mm2/s，兩者之間有統(tǒng)計(jì)學(xué)意義（p0.05）；惡性病變的SlowADC值與FastADC值分別為（0.97±0.28）×10-3mm2/s、（13.85±8.96）×10-3mm2/s，兩者之間亦有統(tǒng)計(jì)學(xué)意義（p0.05）。子宮內(nèi)膜癌和宮頸癌的SlowADC分別為（0.96±0.23）×10-3mm2/s、（0.91±0.29）×10-3mm2/s，兩者間沒(méi)有統(tǒng)計(jì)學(xué)意義（p=0.54）；FastADC值分別為（11.14±6.58）×10-3mm2/s、（17.24±10.49）×10-3mm2/s，兩者間亦沒(méi)有統(tǒng)計(jì)學(xué)意義（p=0.15）。 結(jié)論：DWI技術(shù)是一種快速的、準(zhǔn)確的、無(wú)輻射的成像技術(shù)，且能結(jié)合ADC值的測(cè)量，對(duì)臨床診斷很重要。作為MRI的一種功能成像，從微觀結(jié)構(gòu)監(jiān)測(cè)組織的改變，早于常規(guī)影像學(xué)顯示的形態(tài)改變。本文DWI雙指數(shù)衰減模型使用多種參數(shù)、從多方面描述盆腔腫瘤的特性，在分子水平反映腫瘤組織的改變，比常規(guī)的MRI掃描更早的發(fā)現(xiàn)病灶，，并且通過(guò)對(duì)腫瘤組織定量測(cè)量對(duì)其定性，診斷常規(guī)MRI不能診斷的初級(jí)惡性腫瘤，同時(shí)提供腫瘤的血流灌注情況，有望代替增強(qiáng)掃描，避免有創(chuàng)檢查及造影劑的后期肝腎損害。為鑒別盆腔良、惡性腫瘤提供豐富的鑒別診斷依據(jù)，但對(duì)腫瘤的病理類型的鑒別沒(méi)有統(tǒng)計(jì)學(xué)意義，這可能本文病例數(shù)較少有關(guān)。
[Abstract]:Objective: to scan the female pelvic cavity with 3.0 T MRI and treat the lesion with multiple b value double exponential attenuation model. By recording various parameters and comparing them with various methods, we can explore whether the multi b value double exponential attenuation model is good in the pelvic cavity. Value of differential diagnosis in malignant lesions. Materials and methods: MR750-DWI scanning was performed on 69 lesions in 56 patients, including 35 benign lesions: 12 leiomyomas, 12 cysts, 6 chocolate cysts, 3 cystadenomas and 2 teratoma. 34 malignant lesions: 16 cervical carcinomas (all squamous cell carcinomas, 15 endometrial carcinomas, 3 adenocarcinoma and 3 ovarian carcinomas). The b value was set to 0 50 ~ 300 ~ 600 ~ (600) ~ 800 ~ 1200s / mm ~ (2). The mean value of three measurements was taken by AW451 workstation and Functool-MADC software. Region of interest (region of interest): select areas with large cross section and uniform density, avoid cystic degeneration, necrosis, bleeding, measure solid parts of cystadenoma, measure fat content in teratoma. The area of the area of interest measured three times is as consistent as possible (no more than 20mm ~ 2mm). The SlowADC value and the standard ADC value are recorded and compared respectively. Finally, the axial T2 fat suppression image is fused with the StandardADC image. It can better display the structure of the pelvic cavity and locate the tumor more accurately. Comparing the high incidence endometrial carcinoma and cervical cancer to see the value of multiple b value double exponential attenuation model in differentiating the pathological types of malignant tumors. Results: the SlowADC value of benign lesions was 1.74 鹵0.89 脳 10-3 mm ~ (-2) / s and the value of SlowADC was 1.73 鹵0.79) 脳 10 ~ (-3) mm ~ 2 / s, which was higher than that of malignant tumors [SlowADC = 0.97 鹵0.28) 脳 10 ~ (-3) mm ~ (2 / 2) 脳 10 ~ (-3) mm ~ (2 / s). The SlowADC values of benign and malignant lesions were significantly higher than those of benign and malignant lesions (P < 0.05). In addition, there were significant differences between benign and malignant lesions. The FastADC value of benign and malignant lesions was higher than that of SlowADC. The SlowADC values of benign lesions were 1.74 鹵0.89) 脳 10-3 mm ~ (-2) / s, respectively (15.94 鹵9.01) 脳 10 ~ (-3) mm ~ (2) / s (P = 0.05), and the SlowADC and FastADC values of malignant lesions were 0.97 鹵0.28) 脳 10 ~ (-3) mm / s 13.85 鹵8.96 脳 10 ~ (-3) mm ~ 2 / s, respectively. The SlowADC of endometrial carcinoma and cervical carcinoma were 0.96 鹵0.23 脳 10 ~ (-3) mm ~ (-2) P ~ (-1) 0.91 鹵0.29) 脳 10 ~ (-3) mm ~ 2 / s, respectively. There was statistical significance (P = 11.14 鹵6.58) 脳 10 ~ (-3) mm ~ (2) / s = 17.24 鹵10.49) 脳 10 ~ (-3) mm ~ (2 / s), and there was no significant difference between them. ConclusionDWI is a rapid, accurate, radiation-free imaging technique, which can be combined with the measurement of ADC value, which is very important for clinical diagnosis. As a functional imaging of MRI, the changes of tissue are monitored from the microstructure. The DWI double exponential attenuation model uses a variety of parameters to describe the characteristics of pelvic tumors in many ways and reflect the changes of tumor tissues at the molecular level. The lesions were detected earlier than conventional MRI scans. And through the quantitative measurement of tumor tissue, the diagnosis of primary malignant tumor, which can not be diagnosed by conventional MRI, and at the same time provide the blood flow perfusion of the tumor, which is expected to replace the enhanced scan. In order to differentiate benign and malignant tumors from pelvic cavity, there is abundant basis for differential diagnosis, but there is no statistical significance in the differentiation of pathological types of tumors, which may be related to the small number of cases in this article.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R445.2;R737.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前5條

1 任靜;宦怡;常英娟;趙海濤;葛雅麗;張勁松;劉燕麗;徐俊卿;;前列腺癌多b值擴(kuò)散加權(quán)成像研究[J];實(shí)用放射學(xué)雜志;2008年04期

2 儲(chǔ)彩婷;李文華;殷勝利;張忠陽(yáng);張萍;張韶珍;;擴(kuò)散加權(quán)成像在卵巢囊性病變的初步應(yīng)用[J];中國(guó)醫(yī)學(xué)計(jì)算機(jī)成像雜志;2008年03期

3 陳龍興;程鳴;楊世塤;;子宮附件良性囊性病變的CT診斷[J];中國(guó)醫(yī)學(xué)計(jì)算機(jī)成像雜志;2008年03期

4 袁曉春;王夕富;鄭林豐;姚戈虹;胡運(yùn)勝;張貴祥;;3.0T MR彌散加權(quán)成像對(duì)子宮內(nèi)膜病變的診斷價(jià)值[J];中國(guó)醫(yī)療器械信息;2010年10期

5 ;MR diffusion-weighed imaging of rabbit liver[J];World Journal of Gastroenterology;2005年35期

本文編號(hào)：1532667