發(fā)布時(shí)間：2018-06-08 20:54

  本文選題：擴(kuò)散峰度成像 + 多參數(shù)　； 參考：《青海大學(xué)》2017年碩士論文

【摘要】：目的探討磁共振擴(kuò)散峰度成像(DKI)的多參數(shù)值對(duì)高級(jí)別膠質(zhì)瘤(HGG)和單發(fā)腦轉(zhuǎn)移瘤(SBM)的鑒別能力。方法收集經(jīng)手術(shù)病理證實(shí)或臨床隨訪證實(shí)的HGG患者19例和SBM患者14例,所有患者治療前均行常規(guī)MRI掃描、DKI掃描及增強(qiáng)掃描。選取感興趣區(qū)(ROI)測定其DKI各參數(shù)值,并進(jìn)行矯正處理后得到各向異性分?jǐn)?shù)(FA)值、平均擴(kuò)散(MD)值及平均峰度(MK)值。應(yīng)用獨(dú)立樣本t檢驗(yàn)對(duì)兩組間各參數(shù)值進(jìn)行統(tǒng)計(jì)學(xué)分析,有統(tǒng)計(jì)學(xué)意義的參數(shù)繪制受試者工作特征曲線(ROC)。結(jié)果HGG組實(shí)質(zhì)區(qū)及瘤周區(qū)的FA值、MD值及MK值分別為0.432±0.130、1.465±0.402、0.652±0.188;0.176±0.047、1.766±0.326、0.565±0.083。SBM組實(shí)質(zhì)區(qū)及瘤周區(qū)的FA值、MD值及MK值分別為0.383±0.120、1.647±0.332、0.717±0.176;0.142±0.037、2.024±0.221、0.460±0.057。實(shí)質(zhì)區(qū)DKI各參數(shù)值在兩組間的差異均無統(tǒng)計(jì)學(xué)意義;而瘤周區(qū)的FA值、MD值及MK值在兩組間的差異有統(tǒng)計(jì)學(xué)意義(P0.05)。ROC曲線分析顯示,瘤周區(qū)FA值臨界值為0.161時(shí),鑒別兩種腫瘤的敏感性為68.4%,特異性為71.4%,曲線下面積為0,722;瘤周區(qū)MD臨界值為1.910時(shí),其敏感性為73.7%,特異性為71.4%,曲線下面積為0.756;瘤周區(qū)MK值臨界值為0.516時(shí),其敏感性為84.2%,特異性為85.7%,曲線下面積為0.865。瘤周區(qū)的MK值在鑒別兩種腫瘤時(shí)敏感性、特異性較FA值、MD值更高,且其曲線下面積最大。結(jié)論瘤周區(qū)的FA值、MD值及MK值對(duì)HGG和SBM有良好的鑒別診斷價(jià)值,且瘤周區(qū)MK值診斷效能最高。
[Abstract]:Objective to investigate the differential value of Mr diffusion kurtosis imaging (DKI) for high grade glioma (HGG) and single metastatic tumor (SBM). Methods 19 cases of HGG and 14 cases of SBM confirmed by operation and pathology or clinical follow-up were collected. All the patients were examined by conventional MRI and enhanced MRI before treatment. The values of DKI parameters were measured by ROI, and the values of anisotropic fractions (FAs), mean diffusivity (MD) and mean kurtosis (MK) were obtained after correction. The independent sample t-test was used to analyze the values of each parameter between the two groups, and the statistically significant parameters were used to draw the operating characteristic curve of the subjects. Results the FA values and MK values of parenchymal and peritumorous areas in HGG group were 0.432 鹵0.130 鹵1.465 鹵0.402 鹵0.652 鹵0.188 0.176 鹵0.047 鹵1.766 鹵0.3260.65 鹵0.083.SBM, the FA values of MD and MK were 0.383 鹵0.120 鹵1.647 鹵0.332W 0.717 鹵0.1760.142 鹵3772.024 鹵0.2210.460 鹵0.0577.The values of FA and MK in parenchymal and peritumoral areas were 0.383 鹵0.120, 1.647 鹵0.332n, 0.717 鹵0.1760.142 鹵3,72.24 鹵0.2210.460 鹵0.057, respectively. There was no significant difference in DKI parameters between the two groups, but the difference of FA value and MK value between the two groups was statistically significant (P < 0.05). The critical value of FA value was 0.161. The sensitivity was 68.4%, specificity 71.4, area under curve 0722, critical value of MD 1.910, sensitivity 73.775, specificity 71.4, area under curve 0.756, critical value of MK 0.516. The sensitivity was 84.2 and the specificity was 85.7.The area under the curve was 0.865. The sensitivity and specificity of MK value in the peripheral region of tumor were higher than that of FA value and MD value, and the area under the curve was the largest. Conclusion the FA value and MK value of the tumor zone have good value in differential diagnosis of HGG and SBM, and the value of MK value is the most effective in the diagnosis of HGG and SBM.
【學(xué)位授予單位】：青海大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R445.2;R739.41

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