本文選題：T1ρ + MR成像　； 參考：《南京大學(xué)》2017年碩士論文

【摘要】：第一部分Tiρ磁共振成像對(duì)干燥綜合征的早期診斷研究目的:探測(cè)旋轉(zhuǎn)框架內(nèi)自旋晶格弛豫時(shí)間(T1ρ)MR成像對(duì)干燥綜合征(Sjogren's syndrome,SS)早期診斷的價(jià)值。方法:對(duì)32名腮腺無(wú)形態(tài)學(xué)改變的SS患者和32名性別、年齡匹配的健康志愿者行3.0TMR檢查,包括Tiρ序列。3個(gè)月后采用相同序列重復(fù)掃描。配對(duì)t檢驗(yàn)比較雙側(cè)腺體T1信號(hào)和Tiρ值。獨(dú)立樣本t檢驗(yàn)比較志愿者與SS患者T1信號(hào)和Tiρ值。使用ROC曲線評(píng)估Tiρ值的診斷價(jià)值。組內(nèi)相關(guān)系數(shù)(ICC)評(píng)估腮腺Tiρ測(cè)量的可重復(fù)性。結(jié)果:SS患者和健康志愿者的雙側(cè)腺體T1信號(hào)和Tiρ值無(wú)差異性(P分別為0.170,0.886,0.942和0.229)。SS患者與健康志愿者的T1值無(wú)差異性(P = 0.655)。SS患者的Tiρ值(96.47± 15.38 ms)顯著高于健康志愿者(84.25 ± 6.11 ms,P0.001)。Tiρ值診斷SS的閾值為88.02 ms,診斷的靈敏度和特異度分別為75.0%和100.0%。Tiρ測(cè)量的可重復(fù)性優(yōu)(ICC:0.934～0.995)。結(jié)論:Tiρ MR成像可以有效診斷腮腺腺體無(wú)形態(tài)學(xué)改變的SS患者。第二部分 體素內(nèi)不相干運(yùn)動(dòng)成像在干燥綜合征腮腺損傷分級(jí)中的應(yīng)用目的:探索體素內(nèi)不相干運(yùn)動(dòng)(Intravoxel incoherent motion,IVIM)磁共振(Magnetic resonance,MR)成像參數(shù)和干燥綜合征(Sjogren's syndrome,SS)患者腮腺腺體MR結(jié)節(jié)分級(jí)的相關(guān)性。方法:31位確診的SS患者和28名性別、年齡匹配的健康志愿者行3.0T MR腮腺檢查。IVIM檢查序列包括9 b值,范圍為0～800 s/mm2。雙側(cè)腺體的表觀擴(kuò)散系數(shù)ADC,擴(kuò)散系數(shù)D,偽擴(kuò)散系數(shù)D*和灌注分?jǐn)?shù)f,并根據(jù)MR形態(tài)學(xué)表現(xiàn)對(duì)腮腺實(shí)質(zhì)進(jìn)行結(jié)節(jié)分級(jí)。結(jié)果:31位SS患者共62個(gè)腺體,MR結(jié)節(jié)分級(jí)為0,1,2,3級(jí)的分別有32,14,8和8個(gè)腺體。腺體分級(jí)為0,1,2和3級(jí)以及志愿者的ADC值分別為(1.13± 0.25,1.11 ± 0.17,1.05 ± 0.24,0.89 ± 0.04,1.00 ± 0.21)×10-3mm-2/s,D 值分別為(0.92 ± 0.13,0.90 ± 0.19,0.90 ± 0.03,0.67 ± 0.03,0.81 ± 0.03)×10-3Omm2/s,f 值分別為 0.20 ± 0.04,0.18 ± 0.02,0.15 ± 0.01,0.11 ± 0.01,0.15 ± 0.06,和 D*值分別為(53.89 ± 28.26,41.78 ± 16.35,51.24 ± 18.69,31.83 ± 18.03,36.83 ± 16.14)x10-3 mm2/s。0級(jí)SS患者腺體的ADC,D,f和D*值均顯著高于健康志愿者(P值均0.05)。SS患者級(jí)別間D和f值具有顯著統(tǒng)計(jì)學(xué)差異(P值分別為0.003,0.001)。在早期(分級(jí)0～1級(jí))SS患者的D和f值顯著高于健康志愿者,而進(jìn)展期(分級(jí)2～3級(jí))SS患者的D和f值顯著低于健康志愿者(P值均0.05)。參數(shù)D和f值與MR結(jié)節(jié)分級(jí)呈顯著正相關(guān)(系數(shù)分別為r =-0.297,P = 0.019;r =-0.653,P0.001)。結(jié)論:腮腺不同MR結(jié)節(jié)分級(jí)的SS患者,反映了腺體在不同時(shí)期具有不同的病理生理特征。
[Abstract]:Part I: early diagnosis of Sjogren's Syndrome with Ti 蟻 Magnetic Resonance objective: to investigate the value of detecting spin lattice relaxation time and T 1 蟻 Mr imaging in the early diagnosis of Sjogren's syndrome (SS). Methods: 3.0TMR was performed in 32 SS patients with no morphologic changes of parotid gland and 32 healthy volunteers with gender and age matching, including Ti 蟻 sequence, and repeated scanning with the same sequence 3 months later. The T 1 signal intensity and Ti 蟻 value of bilateral glands were compared by paired t test. T-test was used to compare T 1 signal intensity and Ti 蟻 value between volunteers and SS patients. The diagnostic value of Ti 蟻 value was evaluated by ROC curve. The reproducibility of Ti 蟻 measurement in parotid gland was evaluated by ICC- (intra-group correlation coefficient). Results there was no difference in T1 signal intensity and Ti 蟻 value of bilateral glands between the two groups (P = 96.47 鹵15.38 Ms, P = 96.47 鹵15.38 Ms), P = 96.47 鹵15.38 Ms, P = 96.47 鹵15.38 Ms, P = 96.47 鹵15.38 Ms, P = P = 96.47 鹵15.38 Ms, P = 96.47 鹵15.38 Ms, P = P = 96.47 鹵15.38 Ms, P = P = 96.47 鹵15.38 Ms, respectively. The diagnostic threshold of SS was 88.02 Ms, the diagnostic sensitivity and specificity were 75.0% and the repeatability of 100.0%.Ti 蟻 was better than that of ICC: 0.934 / 0.995ms. Conclusion: t Ti 蟻 Mr imaging can effectively diagnose SS patients with no morphologic changes of parotid gland. Application of voxel incoherent motion imaging in the classification of parotid gland injury in Sjogren's syndrome objective: to explore the imaging parameters of intra voxel incoherent motif and Sjogren's syndromesia in patients with Sjogren's syndrome. Correlation of Mr nodule grading. Methods Thirty one confirmed SS patients and 28 age matched healthy volunteers underwent 3.0T Mr parotid gland examination. IVIM sequence consisted of 9 b values in the range of 0 ~ 800 s / mm ~ (2). The apparent diffusion coefficient (ADCD), diffusion coefficient (D), pseudo-diffusion coefficient (D *) and perfusion fraction (f) of bilateral glands were classified according to the morphologic features of parotid gland. Results in 31 patients with SS, there were 32 cases with Mr grade 0 1 and 2 grade 3 with 8 glands. The ADC values of the patients with 0 ~ 1g ~ (-2) and 3 ~ (th) glandular grade were 1.13 鹵0.251.11 鹵0.171.05 鹵0.24 鹵0.24 鹵1.00 鹵0.21) 脳 10 ~ (-3) mm ~ (-2) 路s ~ (-1) D = 0.92 鹵0.130.90 鹵0.190.90 鹵0.03 鹵0.67 鹵0.03 鹵0.81 鹵0.03) 脳 10 ~ (-3) Omm _ 2 / sf = 0.20 鹵0.04 鹵0.18 鹵0.020.15 鹵0.011 鹵0.01 鹵0.15 鹵0.06, respectively, and the D * values were 0.53 鹵0.089 鹵0.89 鹵0.06, respectively, and the values of D * were 0.20 鹵0.04 鹵0.18 鹵0.020.15 鹵0.021 鹵0.15 鹵0.06 鹵0.06 and 0.93 鹵0.130.90 鹵0.190.90 鹵0.03 鹵0.81 鹵0.03 鹵0.81 鹵0.03, respectively. The ADF and D * values of the glands in the patients with SS were significantly higher than those in the healthy volunteers (P = 0.0030.001, P = 0.003, P = 0.003, P = 0.003, P = 0.003, P = 0.003, P = 0. 001, P = 0. 0030. 001P, P = 0. 0030. 001respectively). The values of D and D * in the glands of the patients with SS were significantly higher than those of the healthy volunteers (P = 0. 0030. 001). In the early stage (grade 0 ~ 1), the D and f values of SS patients were significantly higher than those of healthy volunteers, while the D and f values of patients with advanced stage SS were significantly lower than those of healthy volunteers (P = 0.05). The parameters D and f were positively correlated with Mr nodule grading (r = 0.297, P = 0.019 ~ 0.653U, P = 0.001, respectively). Conclusion: SS patients with different Mr nodule grades in parotid gland reflect different pathophysiological characteristics of glands at different stages.
【學(xué)位授予單位】：南京大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R445.2;R593.2
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本文編號(hào)：1977583