本文選題：核磁共振　切入點：乳房體積　出處：《吉林大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的 探討MRI三維重建測量不同年齡段女性乳房體積及腺體層體積的變化，并初步界定乳房、乳腺體積測量過程中的閾值范圍。 方法 選擇2013年2月-2013年11月合計508例患者MRI平掃+增強+彌散檢查數(shù)據(jù)，其中門診患者245例，住院手術患者263例，均為女性患者，年齡11歲至87歲，平均43.63+10.94歲�；颊吒┡P位，雙乳自然下垂行胸部MRI掃描，掃描范圍自鎖骨向下至肋下緣，掃描序列包括冠狀位T1WI，矢狀位T2WI脂肪抑制，擴散加權成像及動態(tài)增強掃描。掃描參數(shù)：T1加權像，單一橫斷位，層厚1mm，掃描圖像經(jīng)數(shù)字接口傳至GE公司圖形工作站。以醫(yī)學數(shù)字圖像和通訊標準格式DICOM3.0(Digital Imaging and Communications in Medicine)輸出、保存。將保存的DICOM格式的圖像全部拷貝到分析用計算機，打開Mimics15.0，選擇Import Images，選中一名患者的所有MRI圖像，導入軟件中。在Mimics15.0平臺下進行乳房組織的范圍選取和三維重建，，先設定三維模型的生成范圍為乳房周圍的立方體區(qū)域，之后調(diào)整圖像的對比度，使該區(qū)域的不同亮度的組織的邊界更為清晰，然后通過設定合適的灰度閾值完成對乳房組織的選取，最終通過對全部選定區(qū)域的三維計算，生成雙側(cè)乳房的三維模型。同理，通過設定合適的灰度閾值完成對乳房中腺體組織的選取，進而生成腺體的三維模型。Mimics提供了直接對三維模型進行體積測量的功能，通過查看乳房和腺體三維模型的屬性，便可顯示其具體的體積數(shù)值。 結果 1，隨著年齡變大，乳房和腺體的閾值范圍呈現(xiàn)先上升后下降的趨勢。 2，40-49歲患者進行乳房普查和就診的比例約占全部患者比例的一半，遠遠超過了其他年齡段，其次是30-39歲和50-59歲患者。40-49歲年齡段正是女性乳腺癌高發(fā)年齡段，這一年齡段女性對自身乳房健康的關注程度遠高于其他年齡段。 3，隨著年齡增加，乳房體積基本呈增加趨勢，而乳腺體積于20-29歲達到高峰，之后呈下降趨勢。這說明隨著年齡的增加，乳房體積的增加是由于乳房中的脂肪組織增加引起的。 4，隨著年齡增加，%FGV（%FGV：absolute fibroglandular volume）在20-29歲達到高峰，之后呈下降趨勢，且從20-29歲到30-39歲及40-49歲到50-59歲下降幅度比較大。 5，縱觀各個年齡段，不論乳房體積的比較，還是乳房腺體體積的比較，90%以上患者都是右乳大于左乳，且30-39歲、40-49歲、50-59歲三個年齡段患者左右乳房體積大小差異具有統(tǒng)計學意義（p＜0.05）。結論 1，通過508例乳腺疾病患者乳房體積的測量，對閾值的調(diào)整會有個基本的范圍，確定操作方法及閾值數(shù)值，是我們首要的工作； 2，我們應用解剖學對乳房的定義，確定了在MRI下劃分乳房區(qū)域的問題； 3，整體患者中，通過雙乳MRI體積測量，發(fā)現(xiàn)90%以上人的右側(cè)乳房大于左側(cè)乳房體積，且30-39歲、40-49歲、50-59歲三個年齡段患者左右乳房體積大小差異具有統(tǒng)計學意義（p＜0.05）； 4，通過508例乳腺核磁的體積測算及年齡段間的對比，我們得到了一個結論：隨著年齡的增大、脂肪的堆積，乳房的整體體積是不斷增加的，但腺體層在不斷縮小。
[Abstract]:objective
Objective to investigate the changes of breast volume and gland volume in different age groups by MRI three-dimensional reconstruction, and to define the threshold range of breast volume measurement.
Method
In February 2013 -2013 year in November a total of 508 cases of the MRI scan + + enhanced diffusion test data, including 245 cases of patients, 263 cases of hospitalized patients were female patients, aged 11 to 87 years old, the average age of 43.63+10.94. The patients in the prone position, the breasts naturally underwent chest MRI scan, scan range from the clavicle down to the costal margin scanning sequence including coronal T1WI, sagittal T2WI fat suppression, diffusion weighted imaging and dynamic contrast-enhanced scan. The scan parameters: T1 weighted images, single cross section, thickness 1mm, scanning image through a digital interface to GE graphics workstation. The standard format of digital medical image and communication DICOM3.0 (Digital Imaging and Communications in Medicine) output, saved. Save the image in DICOM format are copied to the analysis by computer, open the Mimics15.0, select Import Images, select an image of all MRI patients, Into the software. In the range of breast tissue under Mimics15.0 platform selection and 3D reconstruction, 3D model generation range set for the cube area around the breast, after adjusting the contrast of the image, so that the region of different brightness organizational boundaries more clearly, and then by setting the appropriate gray threshold completed the selection of the breast the organization, finally based on the three-dimensional calculation all selected regions, to generate three-dimensional model of bilateral breast. Similarly, by setting a proper threshold to complete the selection of gray glandular tissue in the breast,.Mimics 3D model and generate gland provides direct volume measurement of the function of the three-dimensional model, the 3D model and view the properties of breast glands that can display the specific volume value.
Result
1, as the age became larger, the threshold of the breast and glands increased first and then decreased.
2,40-49 years old patients with breast screening and treatment accounts for about half of all patients, far more than other age groups, followed by the 30-39 and 50-59 year old patients.40-49 years of age is the high incidence of breast cancer in women age, this age women pay attention to their breast health is far higher than other age groups.
3, with the increase of age, the volume of breast basically increased, while the breast volume reached the peak at 20-29 years old. Then it showed a downward trend. This indicates that the increase of breast volume is due to the increase of adipose tissue in the breast as the age increases.
4, with age increasing,%FGV (%FGV:absolute fibroglandular volume) peaked at 20-29 years old, then decreased, and decreased from 20-29 to 30-39 years old, 40-49 to 50-59 years old.
5, in all ages, no matter the comparison of breast volume or breast gland volume, more than 90% of the patients had right breast milk than those of left breast. The difference of size between left and right breast of 30-39 years old, 40-49 years old, 50-59 year old three age group was statistically significant (P < 0.05).
1, through the measurement of breast volume in 508 cases of breast disease, the adjustment of threshold will have a basic range. Determining the operation method and threshold value is our primary task.
2, we apply the definition of the anatomy to the breast, and determine the problem of the division of the breast region under MRI;
3, the overall volume of MRI patients, through the breasts measurement, found that more than 90% people more than the right side of the breast and the left breast volume, 30-39 years old, 40-49 years old, 50-59 years old was statistically significant in three age patients about breast size differences (P < 0.05);
4, through 508 cases of breast NMR volume calculation and age comparison, we got a conclusion: with the increase of age, fat accumulation, the overall volume of breast is increasing, but the gland layer is shrinking.

【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R445.2;R655.8

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