本文選題：磁共振成像 + 擴散張量成像��； 參考：《重慶醫(yī)科大學(xué)》2016年碩士論文

【摘要】：第一章 DTI對復(fù)發(fā)-緩解型多發(fā)性硬化患者雙側(cè)視放射的研究目的:應(yīng)用DTI(diffusion tensor imaging)技術(shù)探討復(fù)發(fā)-緩解型多發(fā)性硬化(RRMS)患者視力損傷與雙側(cè)視放射白質(zhì)纖維束損傷的相關(guān)性。方法:視力損傷的RRMS患者及年齡與性別相匹配的健康志愿者各25例行DTI檢查,分別測量雙側(cè)視放射的FA值及MD值,并采用擴展殘疾狀態(tài)量表(EDSS)對患者進行評分。應(yīng)用SPSS17.0配對t檢驗及兩樣本t檢驗分別分析RRMS患者及健康對照組組內(nèi)及組間兩側(cè)視放射的FA值及MD值,以及與EDSS評分的相關(guān)性。結(jié)果:(1)健康對照組及患者組組內(nèi)雙側(cè)視放射FA值(t=0.41,P=0.68;t=0.09,P=0.92)及MD值(t=0.72,P=0.48;t=0.20,P=0.84)均沒有顯著差異(P0.05);多發(fā)性硬化患者左右兩側(cè)視放射FA值(t=8.29,P=0.00;t=8.42,P=0.00)均比正常對照組顯著下降,MD值(t=7.17,P=0.00;t=6.58,P=0.000)均比正常對照組顯著升高(P0.05);(2)雙側(cè)視放射FA值(r=-0.244,P=0.30;r=-0.133,P=0.58)及MD值(r=0.160,P=0.50;r=0.307,P=0.19)與EDSS評分均沒有明顯的相關(guān)性(P0.05)。結(jié)論:RRMS患者視力受損與雙側(cè)視放射的白質(zhì)纖維束損害相關(guān);DTI作為一種無創(chuàng)定量測量白質(zhì)纖維束的MRI檢查方法,可為RRMS患者視力損害病理改變提供影像學(xué)幫助。第二章復(fù)發(fā)-緩解型多發(fā)性硬化患者及復(fù)發(fā)型視神經(jīng)脊髓炎患者雙側(cè)視放射的DTI研究目的:運用擴散張量成像(diffusion tensor imaging,DTI)技術(shù)探討復(fù)發(fā)-緩解型多發(fā)性硬化(RRMS)和復(fù)發(fā)型視神經(jīng)脊髓炎(RNMO)患者看似正常視放射區(qū)DTI指標是否存在差異。方法:RRMS患者、RNMO患者及年齡與性別相匹配的健康志愿者各20例行DTI檢查,分別測量雙側(cè)視放射的FA值及MD值,并采用擴展殘疾狀態(tài)量表(EDSS)對兩組患者進行評分。應(yīng)用SPSS17.0配對t檢驗、單因素方差分析及Dunnett-t檢驗分別分析患者組及健康對照組組內(nèi)及組間兩側(cè)視放射的FA值及MD值,以及用Spearman軟件分析DTI定量值與EDSS評分的相關(guān)性。結(jié)果:(1)健康對照組、RRMS及RNMO患者組組內(nèi)雙側(cè)視放射FA值(t=0.41,P=0.68;t=0.10,P=0.92;t=0.63,P=0.54)及MD值(t=0.72,P=0.48;t=0.20,P=0.84;t=0.20,P=0.84)均沒有明顯差異(P0.05);RRMS及RNMO患者組左右兩側(cè)視放射FA值(P=0.00;P=0.00)均比健康對照組顯著下降,MD值(P=0.00;P=0.00)均比健康對照組顯著升高(P0.05);RNMO組雙側(cè)視放射FA值比RRMS組下降(P=0.02),而MD值(P=0.50)無明顯差別;(2)RRMS組及RNMO組雙側(cè)視放射FA值(r=-0.19,P=0.42;r=0.20,P=0.41)及MD值(r=0.11,P=0.64;r=-0.33,P=0.15)與EDSS評分均沒有明顯的相關(guān)性(P0.05)。結(jié)論:RRMS及RNMO患者看似正常的視放射區(qū)均有受累,但二者視放射受累的程度不一致,FA值對鑒別MS及NMO具有潛在的應(yīng)用價值,并可作為監(jiān)測MS及NMO臨床進展的重要生物學(xué)指標。
[Abstract]:Chapter 1 study of dual lateral radiography in patients with relapse-remission multiple sclerosis objective: to investigate the correlation between visual impairment and white matter fiber bundle injury in patients with relapse-remission multiple sclerosis by using DTI(diffusion tensor imaging technique. Methods: 25 RRMS patients with visual impairment and 25 healthy volunteers matched with age and sex were examined by DTI. FA and MD were measured respectively. The patients were evaluated with extended Disability status scale (EDSS). SPSS17.0 paired t test and two sample t test were used to analyze the FA value and MD value of bilateral visual radiation in patients with RRMS and healthy control group, and the correlation between FA and EDSS score. Results (1) there was no significant difference between healthy control group and patient group (P = 0.41) and MD value (t = 0.72 ~ 0.48 ~ 0.48 ~ 0.20 / P ~ (0.84). There was no significant difference between healthy control group and patient group (P ~ (0.05); in patients with multiple sclerosis, there was no significant difference in both sides (t ~ (8.29) P ~ (0. 000) P ~ (0.002) T ~ (8.42) and there was a significant decrease in MD value (t ~ (7.17) P ~ (0.008) P ~ (0.000) in patients with multiple sclerosis. In the irradiation group, there was no significant correlation between EDSS score and FA value (r = 0.244U, P = 0.30U, P = 0.133a, P = 0.58) and MD (n = 0.160, P = 0.307a, P = 0.19) in the two groups (P < 0.05). The results showed that there was no significant correlation between the mean value of FA and the score of EDSS in the exposure group (P < 0.05), but no significant correlation was found between the two groups (P < 0.01) and the EDSS score (P < 0.05). Conclusion as a noninvasive MRI method for quantitative measurement of the white matter bundle in patients with RRMS, the visual impairment associated with the damage of white matter bundles by dual-lateral radiography can provide imaging assistance for the pathological changes of visual impairment in patients with RRMS. Chapter 2 DTI study of dual Lateral Radiography in patients with recurrent and remission multiple Sclerosis and recurrent Optic Neuromyelitis objective: to investigate the recurrence and remission of multiple sclerosis by diffused Zhang Liang diffusion tensor imaging technique Whether there are differences in DTI indices in the seemingly normal visual radiation area in patients with type A optic neuromyelitis (RNMO). Methods 20 patients with RNMO and 20 healthy volunteers with age and sex matched with RRMS were examined by DTI. FA and MD were measured respectively. The patients in both groups were evaluated with extended Disability status scale (EDSS). SPSS17.0 paired t test, single factor analysis of variance and Dunnett-t test were used to analyze the FA and MD values of bilateral visual radiation in patients group and healthy control group, and Spearman software was used to analyze the correlation between DTI quantitative value and EDSS score. Results (1) there was no significant difference in the FA value of RRMS and RNMO patients in the healthy control group and in the patients with RNMO. The values of FA in the RMS and RNMO groups were significantly lower than those in the healthy control group (P 0.00P 0.00P0. 00P) and the MD values of 0. 72P 0. 48t 0. 20 P0. 84t 0. 20 P0. 804 P0. 84) were significantly lower than those of the healthy control group (P 0. 00P 0. 00P 0. 00P 0. 00P 0. 004) and that of the patients with RNMO was significantly lower than that of the healthy control group (P 0. 00P 0. 00P 0. 00P 0. 0. 20 P0. 84t 0. 20 P0. 20 P0. 20 P0. 20 P0. 20 P0. 84). All of them were significantly lower than those of the healthy control group. Compared with RRMS group, there was no significant difference in the FA value of dual lateral radioactivity between RNMO group and RNMO group. There was no significant difference between RMS group and RNMO group. There was no significant correlation between the FA value of RMS group and RNMO group (P 0. 020 P 0. 41) and MD value of 0. 11 ~ 0. 11P ~ (0. 33) P ~ (0. 15) and EDSS score (P ~ (0.05) ~ 0. 05), but no significant difference was found between the two groups (P < 0. 05) and P 0. 05% (P < 0. 05), and no significant difference was found between the two groups (P < 0. 05) and P 0. 05% (P 0. 05) and P 0. 05 (P 0. 05) respectively. Conclusion the apparent normal visual radiation areas in patients with RRMS and RNMO are involved, but the FA values of the two groups have potential application value in differentiating MS from NMO, and can be used as an important biological index to monitor the clinical progress of MS and NMO.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R445.2;R744.5

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