本文選題：動(dòng)態(tài)增強(qiáng)磁共振成像　切入點(diǎn)：前列腺腫瘤　出處：《山東大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:應(yīng)用 Extended Tofts 與 Reference Region model(RRM)兩種藥代動(dòng)力學(xué)模型測(cè)量血管功能參數(shù),比較兩種模型在前列腺癌DCE-MRI診斷中的價(jià)值。并進(jìn)行前列腺癌血管功能參數(shù)與前列腺特異性抗原密度(PSAD)間的相關(guān)性分析。資料和方法:對(duì)31例經(jīng)TRUS或術(shù)后病理證實(shí)的前列腺癌患者(年齡50-81歲,平均62歲)行MRI常規(guī)序列及動(dòng)態(tài)增強(qiáng)MRI掃描,應(yīng)用Omni Kinetics Manual軟件中的Extend Tofts和RRM模型測(cè)量前列腺癌區(qū)與非癌區(qū)的血管功能參數(shù)Ktrans(容量轉(zhuǎn)移常數(shù))、Ve(對(duì)比劑血管外細(xì)胞外液間隙容積比)、Kep(速率常數(shù))及Vp(對(duì)比劑血漿容積比)。采用Kruskal-Wallis檢驗(yàn)比較兩模型中的血管功能參數(shù),并對(duì)個(gè)血管功能參數(shù)的R0C曲線進(jìn)行繪制,評(píng)估兩模型所對(duì)應(yīng)的各參數(shù)診斷前列腺癌的效能。應(yīng)用Spearman秩相關(guān)對(duì)血管功能參數(shù)與PSAD間關(guān)系進(jìn)行檢驗(yàn);P0.05為差異具有統(tǒng)計(jì)學(xué)意義。結(jié)果:1 Extend Tofts模型中癌區(qū)的Ktrans、Kep、Vp及Ve值分別為(0.338±0.157)min-1、(1.678±0.866)min-1 0.014±0.030、0.234±0.119,RRM 中 Ktrans、Kep及 Ve值分別為(3.233±1.650)min-1、(1.126±0.885)min、1.088±0.720。2.兩模型中前列腺癌區(qū)與非癌區(qū)的血管功能參數(shù)Ktrans、Kep及Ve間均有統(tǒng)計(jì)學(xué)意義(P0.05),且癌區(qū)各參數(shù)平均值與非癌區(qū)相比均較高。3.Extend Tofts模型中Ktrans與Kep對(duì)前列腺癌診斷的敏感度及特異度均高于RRM(Ktrans為 91.8%、85.7%,89.8%、81%;Kep 為 93.9%、95.2%,67.3%、81%),Vp 對(duì)前列腺癌診斷的敏感度及特異度低于RRM(分別為38.8%、81.2%;75.5%、85.7%).4.在Extend Tofts 模型中Ktrans與Kep、Ve均呈正相關(guān)(r=0.438、0.511),Ktrans與Vp呈負(fù)相關(guān)(r=-0.561);在RRM中Ktrans與Kep、Vp間均呈正相關(guān)(r=0.624、0.451);兩模型中Ktranss間呈正相關(guān)(r=0.327)。5.在Extend Tofts模型中,PSAD與Kep、Ve具有相關(guān)性(r=-0.414,0.420),與其它血管功能參數(shù)不具有相關(guān)性。結(jié)論:Extended Tofts模型更適于前列腺癌的診斷,其中血管功能參數(shù)Ktrans、Kep對(duì)前列腺癌的診斷效能最高,且PSAD與K_(ep)、V_e具有相關(guān)性。
[Abstract]:Objective: to measure vascular function parameters using two pharmacokinetic models: Extended Tofts and Reference Region model RRM. To compare the value of the two models in the diagnosis of prostate cancer with DCE-MRI, and to analyze the correlation between prostate cancer vascular function parameters and prostate specific antigen density (PSA). Data and methods: 31 cases were confirmed by TRUS or postoperative pathology. In patients with prostate cancer, aged 50-81, MRI routine sequence and dynamic enhanced MRI scan were performed. Using the Extend Tofts and RRM models in Omni Kinetics Manual software to measure the vascular function parameters of prostate cancer area and non-cancer area, KtransV (volume transfer constant) and Vp (contrast medium extracellular fluid volume ratio) and VP (contrast medium plasma volume). Kruskal-Wallis test was used to compare the vascular function parameters of the two models. And draw the R0C curve of each vascular function parameter, Spearman rank correlation was used to test the relationship between vascular function parameters and PSAD. Results Ktrans1 Extend Tofts model had significant difference in the diagnosis of prostate cancer. Results Ktrans1 Extend Tofts model had a significant difference in the relationship between vascular function parameters and PSAD. Results Ktrans1 Extend Tofts model showed that there was a significant difference in the relationship between vascular function parameters and PSAD. The values of Ktransmeg Kep and ve in the RRM of 0.338 鹵0.157 min -1 and 1.678 鹵0.866 min -1 0.014 鹵0.030 鹵0.234 鹵0.19 min were 3.233 鹵1.650 min -1, 1.126 鹵0.885min 1.088 鹵0.720.2.There was statistical significance between the two models in the blood vessel function parameters of the prostate cancer area and the non-cancer area, and the mean value of each parameter in the cancer area was higher than that in the non-cancerous area. 3.Extended Tofts model was higher than that in the non-cancer area. The sensitivity and specificity of Ktrans and Kep in the diagnosis of prostate cancer were higher than those in RRM(Ktrans. The sensitivity and specificity of Ktrans and Kep in the diagnosis of prostate cancer were higher than those in RRM(Ktrans. The sensitivity and specificity of Ktrans and Kep in the diagnosis of prostate cancer were higher than those in RRM(Ktrans. In the model of Extend Tofts, Ktrans and KepVe were both positively correlated with KepVe 0.8430.5111.The sensitivity and specificity of Kep for the diagnosis of prostate cancer were higher than that of RRM.The sensitivity and specificity of Ktrans and Kep for the diagnosis of prostate cancer were higher than those for RRM(Ktrans. In the model of Extend Tofts, Ktrans and KepVe were positively correlated with Ktrans and VP. There was a positive correlation between Ktrans and Kepan VP in RRM, and a positive correlation between Ktranss and Ktranss in Extend Tofts model. In the Extend Tofts model, there was no correlation between Ktranss and other vascular parameters. Conclusion: the Extend extended Tofts model is more suitable for the diagnosis of prostate cancer. The blood vessel function parameter KTransa Kep was the most effective in the diagnosis of prostate cancer, and PSAD was correlated with KT / V _ e.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R445.2;R737.25

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