【摘要】：目的：研究Gd-EOB-DTPA對(duì)胰腺癌肝轉(zhuǎn)移灶的顯示能力,以及轉(zhuǎn)移灶、化療對(duì)肝實(shí)質(zhì)整體顯示情況的影響,確定病灶最佳觀(guān)察時(shí)間,提高檢出率。方法：收集分析24例胰腺癌患者的肝臟Gd-EOB-DTPA增強(qiáng)MRI圖像。依據(jù)是否伴有肝轉(zhuǎn)移,是否進(jìn)行過(guò)化療對(duì)患者進(jìn)行分別分組。分析所有研究對(duì)象的肝實(shí)質(zhì)SNR情況和轉(zhuǎn)移瘤結(jié)節(jié)的SNR、CNR、CER隋況。比較各組間肝實(shí)質(zhì)SNR是否存在差異,結(jié)節(jié)不同期相的SNR、CER是否有差異,分析轉(zhuǎn)移對(duì)肝實(shí)質(zhì)信號(hào)的影響,化療對(duì)肝實(shí)質(zhì)信號(hào)的影響。繪制時(shí)間-SNR曲線(xiàn)、時(shí)間-CNR曲線(xiàn)和時(shí)間-CER曲線(xiàn),分析病灶信號(hào)改變的情況。結(jié)果：①胰腺癌肝轉(zhuǎn)移瘤在延遲15分鐘的Gd-EOB-DTPA增強(qiáng)磁共振上具有最佳的信號(hào)差別。 ②無(wú)論是否伴有轉(zhuǎn)移瘤,在延遲15分鐘時(shí)肝實(shí)質(zhì)圖像質(zhì)量最佳,但兩組肝實(shí)質(zhì)的各期SNR差值不具有統(tǒng)計(jì)學(xué)意義(P0.05)。③轉(zhuǎn)移瘤陰性的胰腺癌患者,無(wú)論是否進(jìn)行化療,在延遲15分鐘時(shí)肝實(shí)質(zhì)圖像質(zhì)量最佳,但兩組肝實(shí)質(zhì)的各期SNR差值不具有統(tǒng)計(jì)學(xué)意義(P0.05)。④轉(zhuǎn)移瘤非陰性的胰腺癌患者,未化療組在延遲15分鐘時(shí)肝實(shí)質(zhì)圖像質(zhì)量最佳,化療組最佳觀(guān)察時(shí)間在15分鐘之后。但兩組肝實(shí)質(zhì)的各期SNR差值不具有統(tǒng)計(jì)學(xué)意義(P0.05)。⑤掃描序列先后順序的設(shè)定可對(duì)結(jié)節(jié)CER的計(jì)算產(chǎn)生影響。結(jié)論：胰腺癌肝轉(zhuǎn)移瘤在延遲15分鐘的Gd-EOB-DTPA增強(qiáng)磁共振上具有最佳的信號(hào)差別,此時(shí)轉(zhuǎn)移灶能和肝實(shí)質(zhì)形成最大對(duì)比,有利于病灶的發(fā)現(xiàn)和檢出。胰腺癌患者無(wú)論是否伴有肝轉(zhuǎn)移,無(wú)論是否進(jìn)行過(guò)化療,均在延遲15分鐘時(shí)最適合觀(guān)察肝實(shí)質(zhì)情況。
[Abstract]:Aim: to study the display ability of Gd-EOB-DTPA in hepatic metastases of pancreatic cancer and the effect of chemotherapy and chemotherapy on the overall display of hepatic parenchyma, to determine the best observation time and to improve the detection rate. Methods: Gd-EOB-DTPA enhanced MRI images of liver were collected and analyzed in 24 patients with pancreatic cancer. Patients were divided into groups according to whether they had liver metastasis and whether they had been treated with chemotherapy. The SNR of liver parenchyma and the SNR,CNR,CER sui condition of metastatic tumor were analyzed in all subjects. The effects of metastasis on hepatic parenchyma signal and the effect of chemotherapy on hepatic parenchyma signal were analyzed. Time-SNR curve, time-CNR curve and time-CER curve were plotted to analyze the change of lesion signal. Results there was the best signal difference in Gd-EOB-DTPA enhanced MRI with or without 15 minutes delay of 15 minutes in metastatic tumor of pancreatic carcinoma. 2 the liver parenchyma image quality was the best in 15 minutes delay. However, the difference of SNR in each stage of liver parenchyma between the two groups was not statistically significant (P0.05). 3. The liver parenchyma image quality was the best in patients with pancreatic cancer with negative metastasis, whether or not chemotherapy was performed. However, the difference of SNR in each stage of liver parenchyma between the two groups was not statistically significant (P0.05). 4. 4. 4. The liver parenchyma image quality was the best in the non-chemotherapy group at the delay of 15 minutes, and the best observation time in the chemotherapy group was after 15 minutes. However, the difference of SNR in each phase of liver parenchyma between the two groups was not statistically significant (P0.05). 5. The sequence of scanning sequence could affect the calculation of nodular CER. Conclusion: hepatic metastases of pancreatic cancer have the best signal difference on Gd-EOB-DTPA enhanced MRI with a delay of 15 minutes. At this time, the metastatic focus can be compared with the hepatic parenchyma, which is beneficial to the detection and detection of the lesions. The hepatic parenchyma was best observed in pancreatic cancer patients with or without hepatic metastasis and with or without chemotherapy.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R445.2;R735.9

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