本文選題：IVIM + 腦膠質瘤　； 參考：《山西醫(yī)科大學》2017年碩士論文

【摘要】：目的:探討磁共振體素內不相干運動成像(intravoxel incoherent motion,IVIM)在監(jiān)測腦膠質瘤復發(fā)和治療后反應中的應用價值。方法:收集2015年10月至2016年12月術后病理證實為腦膠質瘤且行同步放化療的患者26例(15例腦膠質瘤復發(fā),11例治療后反應),在同步放化療結束2月內行頭部常規(guī)MRI掃描、增強掃描及多b值彌散加權掃描,通過IVIM序列的單指數(shù)及雙指數(shù)模型,對圖像后處理得到standard ADC、slow ADC(D)、fast ADC(D*)、fraction of fast ADC(f)的偽彩圖,分別測量病例異常強化區(qū)standard ADC值、D值、D*值、f值。采用兩樣本t檢驗比較兩組各參數(shù)值是否存在差異,受試者工作特性曲線(ROC)評估各參數(shù)值在監(jiān)測腦膠質瘤復發(fā)和治療后反應中的效能。結果:(1)復發(fā)組的強化病灶standard ADC值(0.852±0.378)低于治療后反應組(1.27±0.551),差異有統(tǒng)計學意義(P=0.031);復發(fā)組的強化病灶D值(0.528±0.228)低于治療后反應組(0.751±0.203),差異有統(tǒng)計學意義(P=0.017);復發(fā)組的強化病灶D*值(2.91±0.62)高于治療后反應組(2.42±0.34),差異有統(tǒng)計學意義(P=0.025);復發(fā)組的強化病灶f值(0.604±0.261)高于治療后反應組(0.394±0.231),差異有統(tǒng)計學意義(P=0.044)。(2)ROC曲線分析,當standard ADC值、D值曲線下面積分別為0.703、0.788時,其閾值分別為1.166、0.631,敏感性分別為54.5%、81.8%,特異性分別為86.7%、73.3%,D值的診斷效能優(yōu)于standard ADC值;ROC曲線分析,當D*值、f值曲線下面積分別為0.752、0.758時,診斷閾值分別為2.642、0.693,敏感性分別為66.7%、81.8%,特異性分別為81.8%、66.7%。結論:IVIM可用于監(jiān)測腦膠質瘤復發(fā)和治療后反應,為腦膠質瘤術后患者的臨床治療提供影像依據(jù)。
[Abstract]:Objective: To investigate the value of intravoxel incoherent motion (IVIM) in the monitoring of recurrent and post treatment response to glioma. Methods: 26 patients (15 cases of glioma recurrence, 11 cases of glioma) were collected from October 2015 to December 2016. In February, routine head MRI scan, enhanced scan and multiple B diffusion weighted scan were performed in February, and the single index and double exponential model of IVIM sequence were used to obtain standard ADC, slow ADC (D), fast ADC (D*) and fraction pseudo color images. D value, D* value, F value. The two sample t test was used to compare the difference between the two groups, and the subjects' work characteristic curve (ROC) was used to evaluate the effectiveness of the parameter values in the monitoring of glioma recurrence and post treatment response. Results: (1) the standard ADC value of the enhanced lesion in the recurrent group (0.852 + 0.378) was lower than that in the post treatment group (1.27 + 0.551). Statistical significance (P=0.031); the D value of the enhanced focus (0.528 + 0.228) in the recurrent group was lower than that in the post treatment group (0.751 + 0.203), and the difference was statistically significant (P=0.017); the D* value of the intensive lesion in the recurrent group was higher than that in the post treatment group (2.42 + 0.34), and the difference was statistically significant (P=0.025), and the F value of the intensive focus of the relapse group was higher (0.604 + 0.261). After the treatment (0.394 + 0.231), the difference was statistically significant (P=0.044). (2) ROC curve analysis, when the standard ADC value and the area under the D value curve were 0.703,0.788, the threshold was respectively 1.166,0.631, the sensitivity was 54.5%, 81.8% respectively, the specificity was 86.7%, 73.3%, D value was better than standard ADC value, ROC curve analysis, When the D* value and the area under the F value curve were 0.752,0.758 respectively, the diagnostic threshold was 2.642,0.693 respectively, the sensitivity was 66.7%, the specificity was 81.8% respectively, the specificity was 81.8% respectively. The 66.7%. conclusion: IVIM can be used to monitor the recurrence and post treatment reaction of glioma, and provide the image basis for the clinical treatment of patients with glioma after operation.

【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R445.2;R739.41

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本文編號：1834818