本文選題：星形細(xì)胞瘤　切入點(diǎn)：腦　出處：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討磁共振多b值DWI水通道蛋白分子成像技術(shù)在腦星形細(xì)胞瘤高低級別鑒別診斷中的價(jià)值。方法:篩選2014年4月至2016年7月期間在我院行手術(shù)治療并證實(shí)為腦星形細(xì)胞瘤的患者總共52例。根據(jù)世界衛(wèi)生組織(world health organization,WHO)2016年中樞神經(jīng)系統(tǒng)腫瘤的分類標(biāo)準(zhǔn)分為兩組,即低級別組(WHO I-II級)24例和高級別組(WHO III-IV級)28例,所有的患者術(shù)前均接受顱腦常規(guī)MRI掃描、常規(guī)DWI掃描及多b值DWI掃描。在GE Adavantage Workstation 4.4工作站進(jìn)行后處理獲得AQP-ADC偽彩圖及常規(guī)ADC偽彩圖,并分別測量腫瘤實(shí)質(zhì)區(qū)及對側(cè)正常白質(zhì)區(qū)的AQP-ADC值及常規(guī)ADC值。采用獨(dú)立樣本t檢驗(yàn)分析高、低級別組腫瘤實(shí)質(zhì)區(qū)及對側(cè)正常白質(zhì)區(qū)的AQP-ADC值及常規(guī)ADC值是否具有統(tǒng)計(jì)學(xué)差異,并利用工作者受試特征(receiver operating characteristic,ROC)曲線分析比較腫瘤實(shí)質(zhì)區(qū)的AQP-ADC值與常規(guī)ADC值對于腦星形細(xì)胞瘤分級的診斷能力。結(jié)果:(1)高低級別組間對側(cè)正常白質(zhì)區(qū)的AQP-ADC值及常規(guī)ADC值無統(tǒng)計(jì)學(xué)差異(P=0.224,P0.05);(2)高低級別組間腫瘤實(shí)質(zhì)區(qū)的AQP-ADC值在高級別組高于低級別組,常規(guī)ADC值在高級別組低于低級別組;以上兩個(gè)參數(shù)在高低級別腦星形細(xì)胞瘤間有統(tǒng)計(jì)學(xué)差異(P0.05);(3)腦星形細(xì)胞瘤腫瘤實(shí)質(zhì)區(qū)的AQP-ADC值、常規(guī)ADC值鑒別高低級別的ROC曲線下面積(area under curve,AUC)分別為0.891、0.778,界值分別為0.120、1.012,敏感性及特異性分別為92.3%及74.1%、84.6%及61.5%。結(jié)論:(1)應(yīng)用多b值DWI水通道蛋白分子成像測定的AQP-ADC值可以鑒別高低級別腦星形細(xì)胞瘤;(2)AQP-ADC值對腦星形細(xì)胞瘤高低級別的鑒別能力高于常規(guī)ADC值。
[Abstract]:Objective: to evaluate the value of magnetic resonance multi-b DWI aquaporin molecular imaging in differential diagnosis of astrocytoma. Methods: surgical treatment was performed in our hospital from April 2014 to July 2016 and confirmed. A total of 52 patients with brain astrocytoma were divided into two groups according to the World Health Organization (WHO) 2016 classification criteria for central nervous system tumors. There were 24 cases of I-II grade in low grade group and 28 cases of WHO III-IV grade in high grade group. All the patients received routine craniocerebral MRI scan before operation. General DWI scan and multi-b value DWI scan. AQP-ADC pseudo-color image and conventional ADC pseudo-color picture were obtained by post-processing on GE Adavantage Workstation 4.4 workstation. The AQP-ADC values and routine ADC values of tumor parenchyma area and contralateral normal white matter area were measured respectively. The AQP-ADC value and routine ADC value of tumor parenchyma area and contralateral normal white matter area in low grade group were analyzed by independent t test. The diagnostic ability of AQP-ADC value of tumor parenchymal area and conventional ADC value in grading of brain astrocytoma was analyzed and compared by using the receiver operating characteristic roc curve. Results the AQP-ADC value and routine of normal white matter area in contralateral normal white matter area between high and low grade group were compared with that of routine ADC value. The AQP-ADC value of tumor parenchyma in the high grade group was higher than that in the low grade group, and the AQP-ADC value of the tumor parenchyma area in the high grade group was higher than that in the low grade group. The conventional ADC value in the high grade group was lower than that in the low grade group, and the AQP-ADC value of the tumor parenchyma of the brain astrocytoma was significantly different between the high and low grade astrocytomas. The area under the ROC curve is 0.891g / 0.778, the boundary value is 0.120,1.012, the sensitivity and specificity are 92.3% and 74.1g / 84.6% and 61.5% respectively. Conclusion the AQP-ADC value can be determined by multi-b-value DWI aquaporin molecular imaging. The value of AQP-ADC in differentiating high and low grade astrocytoma was higher than that of conventional ADC in differentiating high and low grade astrocytoma.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R445.2;R739.4

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