本文選題：急性白血病 + 雙指數(shù)擴散加權(quán)成像�。� 參考：《山西醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的對正常志愿者、急性白血病治療后骨髓未緩解患者(non-remission, NR)、急性白血病治療后骨髓完全緩解患者(complete remission, CR)腰椎行雙指數(shù)擴散加權(quán)成像及b值等于500s/mm2的單指數(shù)擴散加權(quán)成像掃描,通過對雙指數(shù)擴散加權(quán)成像獲得各參數(shù)及ADCsoo值的比較,研究雙指數(shù)擴散加權(quán)成像評估急性白血病(acute leukemia, AL)患者化治療后腰椎骨髓狀態(tài)的能力,初步探討雙指數(shù)擴散加權(quán)成像在AL療效評價中的應(yīng)用價值。 方法對10位正常志愿者、8例急性白血病NR患者、8例急性白血病CR患者行GE1.5T腰椎矢狀位b值等于500s/mm2的單指數(shù)DWI及雙指數(shù)模型擴散加權(quán)掃描(b=0、500、800、1000、1500、1800、2000、2500s/mm2),分別測量多個腰椎椎體骨髓ADC500、ADCslow、 ADCfast、f值。正常志愿者10例(50個椎體),急性白血病NR患者8例(40個椎體)、急性白血病CR患者8例(40個椎體)。1、對正常志愿者組、急性白血病NR組、急性白血病CR組的ADC50o值做組間比較；2、對正常志愿者組、NR組、CR組組內(nèi)的單指數(shù)ADC500值與ADCslow值兩兩比較；3、對正常志愿者組、NR組、CR組的雙指數(shù)模型ADCslow、ADCfast、f值做組間比較；組間計量資料比較采用方差分析,組內(nèi)兩兩比較采用兩獨立樣本t檢驗。 結(jié)果(1)正常志愿者、急性白血病NR患者、急性白血病CR組間單指數(shù)ADCsoo值差異有統(tǒng)計學(xué)意義,正常志愿者與NR組間差異有統(tǒng)計學(xué)意義(p0.05),正常志愿者與CR組間差異有統(tǒng)計學(xué)意義(p0.05),NR組與CR組間差異有統(tǒng)計學(xué)意義(p0.05)(2)正常志愿者、急性白血病NR患者、急性白血病CR組內(nèi)ADC500、ADCslow差異均有統(tǒng)計學(xué)意義(p0.05)(3)正常志愿者、急性白血病NR患者、急性白血病CR組間ADCslow差異無統(tǒng)計學(xué)差異,正常志愿者組與NR組間p=0.040.05,差異有統(tǒng)計學(xué)意義,正常組與CR組間p=0.8990.05,差異無統(tǒng)計學(xué)意義,NR組與CR組間p=0.0390.05,差異有統(tǒng)計學(xué)意義；三組間ADCfast值差異具有統(tǒng)計學(xué)意義,正常志愿者組與NR組間p=0.1860.05,差異無統(tǒng)計學(xué)意義,正常組與CR組間p=0.0760.05,差異無統(tǒng)計學(xué)意義,NR組與CR組間p=0.0040.05,差異有統(tǒng)計學(xué)意義；三組間f值差異具有統(tǒng)計學(xué)意義,正常志愿者組與NR組間p=0.0000.05,差異有統(tǒng)計學(xué)意義,正常組與CR組間p=0.0000.05,差異有統(tǒng)計學(xué)意義,NR組與CR組間p=0.2050.05,差異無統(tǒng)計學(xué)意義。 結(jié)論(1)骨髓擴散加權(quán)掃描圖像質(zhì)量能滿足診斷、測量要求；(2)單指數(shù)ADC5oo值能為急性白血病的治療監(jiān)測提供有價值的信息,ADCslow值較單指數(shù)ADC5oo能更好的反映骨髓腫瘤細(xì)胞數(shù)量信息；(3)ADCslow、ADCfast、f值對急性白血病的療效評價可以提供參考信息,雙指數(shù)擴散加權(quán)成像掃描獲得的參數(shù)對于綜合反映正常志愿者、急性白血病未緩解患者及急性白血病完全緩解患者骨髓的生理狀態(tài)具有價值,但其病理生理學(xué)基礎(chǔ)尚需擴大樣本量進一步研究。
[Abstract]:Objective to perform double index diffusion weighted imaging (DWI) and single exponential diffusion weighted imaging (b) of lumbar vertebrae in normal volunteers, non-remissions (NRV) and complete remissions (CRs) of bone marrow after acute leukemia treatment. By comparing the parameters and ADCsoo values obtained by double exponential diffusion weighted imaging, we studied the ability of double exponential diffusion weighted imaging to evaluate the bone marrow status of lumbar vertebrae after treatment with acute leukemia. To discuss the application value of double exponential diffusion weighted imaging in evaluating the curative effect of AL. Methods 10 normal volunteers and 8 CR patients with acute leukemia were examined with single index DWI of sagittal position b of GE1.5T lumbar vertebrae equal to 500s/mm2, and diffusion weighted double exponential model with diffusion-weighted scanning. The bone marrow ADC500ADCslow-ADCD value of multiple lumbar vertebrae was measured. There were 10 normal volunteers (50 vertebral bodies), 8 acute leukemia NR patients (40 vertebral bodies) and 8 acute leukemia CR patients (40 vertebral bodies). The ADC50o value of CR group was compared between two groups. The single index ADC500 value and ADCslow value of CR group in NR group of normal volunteers were compared with that of ADCslow group, and the double-index model ADCslow-ADDCfastf value of NR group in normal volunteers group was compared among groups. ANOVA was used to compare the measurement data among groups, and two independent samples t test were used to compare the two groups. Results (1) there was significant difference in single index ADCsoo between normal volunteers, NR patients with acute leukemia and CR patients with acute leukemia. There was significant difference between normal volunteers and NR group (p 0.05). There was significant difference between normal volunteers and CR group (P 0.05). There was no significant difference in ADCslow between the acute leukemia CR group and the acute leukemia CR group, but there was a significant difference between the normal volunteers and NR group (p 0.040.05, P < 0.05), and there was no significant difference between the acute leukemia CR group and the acute leukemia CR group. There was no significant difference between normal group and CR group (p 0.0390.05), the difference between three groups was statistically significant, and there was no significant difference between normal volunteers group and NR group (p 0.1860.05), there was no significant difference between NR group and NR group. There was no significant difference between normal group and CR group, there was significant difference between NR group and CR group, and there was significant difference in f value among three groups, and between normal volunteer group and NR group, the difference was statistically significant. The difference between normal group and CR group was statistically significant. There was no significant difference between NR group and CR group. Conclusion 1) the quality of bone marrow diffusion-weighted scanning can be used for diagnosis. The value of single index ADC5oo can provide valuable information for monitoring the treatment of acute leukemia. Compared with single index ADC5oo, it can better reflect the number of bone marrow tumor cells and can provide reference information for the evaluation of the curative effect of acute leukemia. The parameters obtained by double exponential diffusion weighted imaging are valuable to reflect the physiological state of bone marrow in normal volunteers, patients with acute leukemia without remission and patients with complete remission of acute leukemia. But the pathophysiological basis needs to be further studied.
【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】：2014
【分類號】：R733.71;R445.1

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