本文選題：前列腺癌 + 擴(kuò)散張量成像��； 參考：《重慶醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：探討3.0T核磁共振擴(kuò)散張量成像（DTI）與三維氫質(zhì)子波譜成像（3D-1H-MRS）聯(lián)合應(yīng)用于前列腺癌（PCa）的診斷價(jià)值。 方法：45例臨床上高度懷疑的PCa患者同時(shí)行DTI、3D-1H-MRS檢查，，對(duì)照病理學(xué)結(jié)果，分別觀察平均表觀擴(kuò)散系數(shù)（ADC）圖、部分各向異性（FA）圖、MRS波譜圖及擴(kuò)散張量示蹤成像（DTT）圖的變化；分別定量分析外周帶（PZ）、中央?yún)^(qū)（CG）癌區(qū)和非癌區(qū)的ADC值、FA值、（膽堿+肌酐）/枸櫞酸鹽（CC/C）值的差異。通過邏輯回歸構(gòu)建診斷模型，分別對(duì)比分析ADC、FA、DTI、MRS、“DTI聯(lián)合MRS”診斷外周帶及中央?yún)^(qū)癌的受試者工作特征曲線（ROC）下面積（AUC），并計(jì)算DTI、MRS、“DTI和MRS”、“DTI或MRS”的敏感度、特異度、陽性預(yù)測(cè)值、陰性預(yù)測(cè)值。 結(jié)果：38例患者順利通過檢查并獲得可分析圖像。PCa的ADC圖多呈低/稍低信號(hào)，F(xiàn)A圖多呈高/稍高信號(hào)，F(xiàn)A彩圖多呈不規(guī)則扭曲的異常色彩，DTT圖上纖維束明顯紊亂、并癌區(qū)纖維局部連續(xù)性中斷或消失；PCa的Cho波峰不同程度抬高，Cit波峰不同程度降低或未見顯示。無論P(yáng)Z或CG，癌區(qū)的ADC值均顯著低于非癌區(qū)（P＜0.01），癌區(qū)的FA、CC/C值均顯著高于非癌區(qū)（P＜0.01，P＜0.05）。在PZ，“DTI聯(lián)合MRS”的AUC顯著高于單獨(dú)應(yīng)用DTI、MRS（P＜0.01）；在CG，“DTI聯(lián)合MRS”的AUC顯著高于單獨(dú)的DTI（P＜0.01），與MRS無顯著差異（P＞0.05）�！癉TI和MRS”在PZ、CG均獲得最高特異度，顯著高于單獨(dú)的DTI、MRS（P＜0.05）；“DTI或MRS”均獲得最高敏感度，在PZ顯著高于單獨(dú)的MRS（P＜0.01），在CG顯著高于單獨(dú)的DTI（P＜0.01）。 結(jié)論：DTI聯(lián)合3D-1H-MRS較單獨(dú)的DTI、3D-1H-MRS有助于提高PCa的診斷效能。
[Abstract]:Objective: to evaluate the diagnostic value of 3.0T diffusion Zhang Liang DTI and 3D-1H-MRS in the diagnosis of prostate cancer. Methods 45 highly suspected PCa patients were examined by DTI 3D-1H-MRS, and the mean apparent diffusion coefficient (ADCC), partial anisotropy (MA) and diffusion Zhang Liang tracer imaging (DTT) were observed respectively. The difference of ADC value and FA value (choline creatinine / citrate CCR) was analyzed quantitatively in the peripheral zone (PZG), the central region (CGG) and the non-cancerous area (C / C), respectively. The diagnostic model was constructed by logical regression, and the sensitivity and specificity of DTI MRS, DTI and MRS, DTI or MRS were calculated by comparing and analyzing the area under the operating characteristic curve of peripheral zone and central area cancer, "DTI combined with MRS". Positive predictive value, negative predictive value. Results in 38 patients, the ADC images of analyzable images. PCA showed low / slightly low signal signals. Most of them showed high / slightly high signal signals, and most of them showed irregular and distorted abnormal colors. The fiber bundles on the images were obviously disordered. In addition, the local continuity of the fibers in the cancer area was interrupted or disappeared. The Cho peak of PCA was elevated to different degrees, and the peak of the Cho wave was decreased or not shown. No matter PZ or CG, the ADC value in the cancer area was significantly lower than that in the non-cancerous area (P < 0.01), and the CC-C value in the cancer area was significantly higher than that in the non-cancerous area (P < 0.01 P < 0.05). The AUC of "DTI combined with MRS" was significantly higher than that of MRS alone (P < 0.01), and the AUC of "DTI combined with MRS" was significantly higher than that of MRS (P > 0.05). "DTI and MRS" had the highest specificity in PZG. The highest sensitivity was obtained in "DTI or MRS", which was significantly higher in PZ than in single MRS(P < 0.01, and in CG was significantly higher than that of DTI(P < 0.01 in CG. Conclusion compared with DTI 3D-1 H-Mrs alone, the diagnostic efficiency of PCa can be improved by using the combination of 3D-1H-MRS and 7% DTI.
【學(xué)位授予單位】：重慶醫(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;R737.25

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相關(guān)期刊論文 前4條

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