本文選題：磁共振波譜　切入點：淋巴瘤　出處：《福建醫(yī)科大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的探討單體素不同回波時間（TE=30/135ms）和多體素長回波（TE=135ms）MRS在原發(fā)性神經(jīng)系統(tǒng)淋巴瘤（PCNSL）與高級別膠質瘤（HGG）鑒別診斷中的價值。 材料與方法回顧性分析19例PCNSL（13例經(jīng)病理證實，6例經(jīng)診斷性治療確診）和22例HGG（均經(jīng)病理證實）患者影像資料。所有患者均接受Siemens Verio3.0T磁共振儀檢查，均行常規(guī)MRI平掃+增強。19例PCNSL均行單體素短和長回波MRS檢查，其中15例行多體素長回波MRS檢查。22例HGG均行單體素短和長回波MRS及多體素長回波MRS檢查。分析不同TE時間單體素MRS在瘤體中的不同代謝物相對比值，同時分析多體素長回波MRS在瘤體及瘤周中的不同代謝物相對比值。采用獨立樣本t檢驗和ROC曲線分析兩者的代謝物指標，選擇SPSS19.0軟件，P＜0.05有統(tǒng)計學意義。 結果單體素短回波MRS的Cho/Cr和NAA/Cr在PCNSL與HGG的鑒別診斷中均有統(tǒng)計學意義（P＜0.05）；Cho/NAA和Lac+Lip/Cr在兩者的鑒別診斷中均無統(tǒng)計學意義（P＞0.05）。單體素長回波MRS的Cho/Cr、NAA/Cr和Cho/NAA在兩者的鑒別診斷中均有統(tǒng)計學意義（P＜0.05）。多體素長回波MRS瘤體的Cho/Cr、NAA/Cr和Cho/NAA在兩者的鑒別診斷中均無統(tǒng)計學意義（P＞0.05）；瘤周的Cho/Cr、NAA/Cr和Cho/NAA在兩者的鑒別診斷中均無統(tǒng)計學意義（P＞0.05）。選擇ROC曲線的youden指數(shù)最大值作為鑒別診斷PCNSL與HGG的最佳臨界點時，單體素短回波MRS的Cho/Cr、NAA/Cr在兩者的鑒別診斷中的敏感性和特異性分別為57.9%和95.5%、68.4%和90.9%。單體素長回波MRS的Cho/Cr、NAA/Cr、Cho/NAA在兩者的鑒別診斷中的敏感性和特異性分別為42.1%和100%、68.4%和55%、89.5%和59.1%。 結論單體素MRS代謝物是鑒別診斷PCNSL與HGG的有效指標，，多體素長回波MRS鑒別診斷價值有限。
[Abstract]:Objective to investigate the value of different Hui Bo time (TE=30/135ms) and multivoxel long Hui Bo (TE=135ms) MRS in differential diagnosis of primary nervous system lymphoma (PCNSL) and high-grade glioma (HGG).
Materials and Methods Retrospective analysis of 19 cases of PCNSL (13 cases confirmed by pathology, 6 cases diagnosed by the diagnostic treatment) and 22 cases of HGG (confirmed by pathology) imaging data of patients. All patients underwent Siemens Verio3.0T MRI examination, underwent conventional MRI scan and enhanced.19 cases of PCNSL underwent single in the short and long echo MRS examination, 15 cases underwent multi voxel long echo MRS.22 patients HGG underwent single voxel short and long echo MRS and multi voxel MRS long echo examination. TE analysis of different time of single voxel MRS metabolites in different tumor tissues and relative ratio, analysis of different metabolites of multi body long back wave MRS in tumor and peritumoral in relative ratio. Analysis of metabolite indicators of the two independent samples t test and ROC curve, SPSS19.0 software, P < 0.05 was statistically significant.
The results of single voxel short echo MRS Cho/Cr and NAA/Cr in the differential diagnosis of PCNSL and HGG were statistically significant (P < 0.05); Cho/NAA and Lac+Lip/Cr had no statistical significance in the differential diagnosis of (P > 0.05). Single voxel long echo MRS Cho/Cr, NAA/Cr and Cho/NAA had statistical significance in the differential the diagnosis of the two (P < 0.05). Multi voxel long echo MRS tumor Cho/Cr, NAA/Cr and Cho/NAA had no statistical significance in the differential diagnosis of (P > 0.05); peritumoral Cho/Cr, NAA/Cr and Cho/NAA had no statistical significance in the differential diagnosis of (P > 0.05) select the ROC curve. The maximum Youden index as the best critical point of differential diagnosis of PCNSL and HGG, single voxel short echo MRS Cho/Cr, sensitivity and specificity of NAA/Cr in the differential diagnosis of respectively 57.9% and 95.5%, 68.4% and 90.9%. single voxel long echo MRS Cho/Cr, NA The sensitivity and specificity of A/Cr and Cho/NAA in the differential diagnosis were 42.1% and 100%, 68.4% and 55%, 89.5% and 59.1%., respectively.
Conclusion monoxin MRS metabolite is an effective index for differential diagnosis of PCNSL and HGG, and the differential diagnosis of multibody long echo MRS is of limited value.

【學位授予單位】：福建醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R445.2

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