本文選題：前列腺 + 磁共振成像��； 參考：《濱州醫(yī)學(xué)院》2014年碩士論文

【摘要】：目的 本研究采用單次激發(fā)自旋平面回波成像(SE-EPI)技術(shù)對前列腺行磁共振擴(kuò)散張量成像(DTI)掃描,探討外周帶前列腺癌DTI參數(shù)表觀擴(kuò)散系數(shù)(ADC)值和各向異性(FA)值的變化與病理Gleason評分水平的相關(guān)性。方法本研究為回顧性研究,已獲得本單位倫理委員會(huì)批準(zhǔn)可免除患者知情同意權(quán)�；仡櫺苑治鲂谐Ｒ�(guī)MRI和DTI檢查并經(jīng)穿刺活檢或手術(shù)病理結(jié)果證實(shí)的65例外周帶前列腺癌患者進(jìn)行統(tǒng)計(jì)分析,患者年齡范圍為53～81周歲,平均年齡為65.6周歲。在西門子后處理軟件上將前列腺癌患者的DTI圖與常規(guī)T2WI解剖圖融合,由兩位有經(jīng)驗(yàn)的MR診斷醫(yī)師參照病理結(jié)果,在融合圖像上畫取與之對應(yīng)的前列腺癌癌灶區(qū),并測量其ADC值和FA值,經(jīng)三次測量后取其平均值作為最終的ADC值和FA值,與病理結(jié)果Gleason評分相比較,分析兩者的相關(guān)性。根據(jù)Gleason評分將前列腺癌分為低、中、高級別癌三組：Gleason評分7者為低級別癌；=7者為中級別癌；7者為高級別前列腺癌。對三組進(jìn)行統(tǒng)計(jì)學(xué)分析,分別測量每組的平均ADC值和FA值,并在三組間進(jìn)行方差分析。結(jié)果外周帶前列腺癌癌灶區(qū)ADC值和FA值均隨評分的升高呈降低趨勢,兩者均Gleason與評分呈負(fù)相關(guān)關(guān)系(r=-0.731,p0.05；r=-0.606,p0.05)。結(jié)論前列腺癌低、中、Gleason高級別三組中ADC值分別為：(9值和FA值進(jìn)行方差分析發(fā)現(xiàn)均具有差異,且該差異具有統(tǒng)計(jì)學(xué)意義(p0.05)。61±103)×10-6mm2/s、(770±152)×10-6mm2/s.(652±111) ×10-6mm2/s；FA值為(395±60)×10-3、(313±93)×10-3.(235±64)×10-3。三組間ADC結(jié)論前列腺癌區(qū)ADC值和FA值與評分具有相關(guān)性,均呈負(fù)相關(guān)關(guān)系,ADC值和GleasonFA值定量診斷前列腺癌具有可能性,對前列腺癌的分級和預(yù)后的判斷具有重要價(jià)值。目的探討擴(kuò)散張量成像(diffusion tensor imaging, DTI)相關(guān)參數(shù)表觀擴(kuò)散系數(shù)(apparent diffusion coefficient, ADC)值和各向異性(fractional anisotropy, FA)值及擴(kuò)散張量纖維束成像(Diffusion tensor tractography, DTT)對中央腺體(central gland, CG)區(qū)前列腺癌(prostate cancer, PCa)和良性前列腺增生(benign prostate hyperplasia, BPH)的鑒別診斷價(jià)值。方法分析行MRI和DTI檢查并經(jīng)病理證實(shí)的CG-PCa 16例和PH30例,測量兩組病變區(qū)的ADC值和FA值,比較其間是否存在差異。運(yùn)用種子點(diǎn)法對病灶最大層面對前列腺進(jìn)行纖維追蹤,得出DTT圖,由兩名資深放射科醫(yī)生采用四級評分制對其進(jìn)行評分,比較兩組病變區(qū)纖維的走行、密度及連續(xù)性的差異。結(jié)果BPH組ADC值為(1273±163)×10-6 mm2/s, FA值為(356±116)×10-3；CG-PCa組ADC值和FA值分別為(1037±±196)×10-6mm2/s、(407±132)×10-3。兩組間ADC值差異有統(tǒng)計(jì)學(xué)意義（p0.05)；FA值間差異無統(tǒng)計(jì)學(xué)意義(p0.05)。兩名醫(yī)師對兩組DTT圖評分一致性較好(k=0.723),CG-PCa組評分分別為2.9±0.9,2.8±1.0；BPH組為1.8±0.7；1.7±0.8。兩組差異具有統(tǒng)計(jì)學(xué)意義(p均0.05)。結(jié)論DTI相關(guān)參數(shù)ADC值在鑒別CG-PCa口BPH中具有重要價(jià)值,但FA值的意義不大。DTT圖對前列腺的描述更加直觀,對兩者的鑒別具有一定的價(jià)值。
[Abstract]:Objective to investigate the correlation between the apparent diffusion coefficient (ADC) values and the changes of the anisotropy (FA) values of the DTI parameters of the peripheral prostate cancer and the correlation between the changes of the anisotropy (FA) value and the level of the pathological Gleason score by using single excitation spin plane echo imaging (SE-EPI) technique, and to investigate the correlation between the changes of the values of the apparent diffusion coefficient (ADC) and the value of the anisotropy (FA) of the prostate cancer of the peripheral zone. Methods the study was a retrospective study. A retrospective analysis of 65 patients with prostate cancer confirmed by routine MRI and DTI examination and confirmed by biopsy or surgical pathology were analyzed retrospectively. The age range of the patients was 53~81 years old and the average age was 65.6 years old. The post-processing software of SIEMENS will be analyzed. The DTI map of the prostate cancer patients was combined with the conventional T2WI anatomic map. Two experienced MR diagnostics refer to the pathological results, draw the corresponding prostate cancer area on the fusion image, and measure their ADC and FA values. After three measurements, the average value is taken as the final ADC value and the FA value, compared with the Gleason score of the pathological results, The correlation between the two was analyzed. According to the Gleason score, the prostate cancer was divided into three groups: low, middle, and high grade carcinoma: 7 were low grade cancer; =7 was intermediate grade carcinoma; the 7 was high grade prostate cancer. The three groups were analyzed statistically to measure the average ADC value and FA value of each group and to analyze the variance between the three groups. The results were analyzed. The results were analyzed. The results were analyzed in the three groups. The result was the analysis of variance. The result was out of analysis. The result was the result of variance analysis. The result was the result of analysis of variance. The ADC value and FA value of the carcinoma area of the prostate cancer were decreased with the increase of the score. Both Gleason and score were negatively correlated (r=-0.731, P0.05; r=-0.606, P0.05). Conclusion the ADC values in the three groups of high grade prostate cancer were respectively: (9 value and FA value were analyzed by variance analysis, and the difference was unified. Study significance (P0.05).61 + 103) x 10-6mm2/s, (770 + 152) x 10-6mm2/s. (652 + 111) x 10-6mm2/s, FA value of (395 + 60) x 10-3, (313 + 93) x 10-3. (235 + 64) * 10-3. three group ADC conclusion, ADC value and FA value of prostate cancer area are correlated with scores, both have negative correlation, ADC value and quantitative diagnosis of prostate cancer are possible. It is of great value for judging the classification and prognosis of prostate cancer. Objective to explore the apparent diffusion coefficient (apparent diffusion coefficient, ADC) and anisotropy (fractional anisotropy, FA) and diffusion tensor fiber beam imaging (fractional anisotropy, DTI) for diffusion tensor imaging (DTI). DTT) the value of the differential diagnosis of prostate cancer (prostate cancer, PCa) and benign prostatic hyperplasia (benign prostate hyperplasia, BPH) in the central gland (central gland, CG). Methods 16 cases of MRI and pathology confirmed by pathology were analyzed and the values and values of the two groups were measured, and the difference between them was compared. The seed point method was used to track the prostate for fiber tracking on the largest layer of the lesion. The DTT map was obtained by two senior radiologists using a four grade score system. The difference between the fiber walking, density and continuity of the two groups was compared. Results the ADC value of group BPH was (1273 + 163) x 10-6 mm2/s, FA value was (356 + 116) x 10-3; CG-PCa Group ADC value and FA value were (1037 + 196) x 10-6mm2/s and (407 + 132) x 10-3. two groups with statistically significant difference (P0.05), and there was no statistical difference between FA values (P0.05). Two physicians had good agreement on the two groups of DTT graph (k=0.723), CG-PCa group score was 2.9 + 0.9,2.8 1, 1.8 + 0.7, 1.7 + two groups. The difference has statistical significance (P 0.05). Conclusion the ADC value of DTI related parameters is of great value in the identification of CG-PCa mouth BPH, but the value of FA value is not much more intuitive to the description of the prostate, which is of certain value for the identification of the two.
【學(xué)位授予單位】：濱州醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R445.2;R737.25

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相關(guān)期刊論文 前1條

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本文編號：1928662