本文選題：前列腺癌　切入點：動態(tài)增強(qiáng)　出處：《石河子大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：第一部分磁共振動態(tài)增強(qiáng)與擴(kuò)散張量成像對前列腺中央?yún)^(qū)良惡性結(jié)節(jié)的診斷價值目的:探討磁共振動態(tài)增強(qiáng)、擴(kuò)散張量成像及二者聯(lián)合對前列腺中央?yún)^(qū)良惡性結(jié)節(jié)的鑒別診斷價值。方法:回顧性搜集60例前列腺中央?yún)^(qū)有結(jié)節(jié)樣異常信號的患者,均行磁共振T2WI、DTI及DCE掃描。經(jīng)前列腺穿刺活檢病理學(xué)證實:89例中央?yún)^(qū)結(jié)節(jié)中38枚為前列腺癌(PCa),51枚為良性前列腺增生(BPH),測量結(jié)節(jié)的ADC值、FA值、峰值時間(Tmax)、最大信號強(qiáng)度(SImax%)、強(qiáng)化率(R),描述SI-T曲線,比較各參數(shù)在PCa與BPH之間的差異,并進(jìn)行ROC曲線分析。結(jié)果:PCa組與BPH組的ADC值、FA值、Tmax值、R值均具有統(tǒng)計學(xué)差異(P0.05),Slmax%組間差異無統(tǒng)計學(xué)意義(P0.05);PCa的SI-T曲線類型以速升下降型為主,BPH曲線類型以平臺型為主。DCE、DTI及二者聯(lián)合診斷的ROC曲線下面積(AUC)分別是0.87(95%CI0.751-0.942),0.85(95%CI 0.734-0.933),0.94(95%CI 0.837-0.983)。結(jié)論:DTI診斷前列腺中央?yún)^(qū)良惡性結(jié)節(jié)的準(zhǔn)確性高于DCE,兩者聯(lián)合診斷效果更好。第二部分探討DTI定量參數(shù)與前列腺中央?yún)^(qū)惡性結(jié)節(jié)Gleason評分的相關(guān)性目的:探討磁共振彌散張量成像技術(shù)定量參數(shù)ADC值、FA值與前列腺中央?yún)^(qū)癌Gleason評分的相關(guān)性,評價DTI在中央腺前列腺癌Gleason分級中的診斷價值。方法:回顧性搜集經(jīng)穿刺活檢證實的38枚前列腺中央?yún)^(qū)惡性結(jié)節(jié),所有患者均行磁共振DTI掃描,測量結(jié)節(jié)的ADC值及FA值,根據(jù)病理結(jié)果將中央腺前列腺癌分為Gleason評分"f6分,Gleason評分為=7分,Gleason評分"g8分,三組,對三組數(shù)據(jù)進(jìn)行單因素方差分析(one-way ANOVA)。采用Pearson相關(guān)分析檢驗前列腺癌ADC值、FA值與Gleason評分的相關(guān)性。結(jié)果:三組前列腺癌區(qū)平均ADC值分別為(1.373±0.308)×10~(-3)mm~2/s、(1.002±0.20 9)×10~(-3)mm~2/s和(0.746±0.195)×10~(-3)mm~2/s,FA值分別0.375±0.281、0.301±0.231和0.196±0.231;三組ADC值、FA值組間差異均具有統(tǒng)計學(xué)意義(P0.05);前列腺癌灶A(yù)DC值、FA值與Gleason評分之間均呈負(fù)相關(guān)(ADC值r=-0.760,P0.05;FA值r=-0.687,P0.05),Gleason評分越高,ADC值、FA值越小。結(jié)論:前列腺中央?yún)^(qū)癌灶A(yù)DC值、FA值與Gleason評分呈負(fù)相關(guān);DTI有助于中央腺前列腺癌臨床危險度的分級判定。
[Abstract]:The first part of the diagnostic value of dynamic enhanced magnetic resonance imaging and diffusion tensor to central to prostate benign and malignant nodules: To investigate the dynamic enhanced MRI, diffusion tensor imaging and the combination of the two central prostate benign and malignant nodules differential diagnosis. Methods: retrospectively collected 60 cases of prostatic central nodular abnormal signals were received magnetic resonance T2WI, DTI and DCE scanning. By pathological biopsy of the prostate biopsy: 89 cases of central nodules in 38 for prostate cancer (PCa), 51 cases of benign prostatic hyperplasia (BPH), measuring the nodule ADC value, FA value, time to peak (Tmax), maximum intensity (SImax%), strengthening rate (R), description of SI-T curve, the difference of each parameter between PCa and BPH, and the ROC curve was analyzed. Results: PCa group and BPH group, ADC value, FA value, Tmax value, R values were statistically significant differences between the groups (P0.05), Slmax% system Statistically significant (P0.05); SI-T curve type PCa to speed up drop type, BPH type platform type.DCE curve, ROC curve area DTI and the two combined diagnosis under (AUC) were 0.87 (95%CI0.751-0.942), 0.85 (95%CI 0.734-0.933), 0.94 (95%CI 0.837-0.983). Conclusion: the accuracy of DTI diagnosis of benign and malignant prostate central nodules than DCE, combined with better diagnosis effect. The second part discusses the objective relationship between DTI quantitative parameters and Gleason score of prostate central malignant nodules: To explore the magnetic resonance diffusion tensor imaging quantitative parameters ADC value, correlation score and Gleason central prostate cancer FA value to evaluate the diagnostic value of DTI in the central gland Gleason grading of prostate cancer. Methods: retrospectively collected by biopsy confirmed 38 central prostate malignant nodules, all patients underwent magnetic resonance DTI scanning, measuring the nodule AD C鍊煎強(qiáng)FA鍊，

本文編號：1616973