發(fā)布時(shí)間：2018-06-26 04:01

  本文選題：磁共振波譜成像 + 磁共振彌散成像　； 參考：《安徽醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的初步探討磁共振波譜成像（MRS）中的枸櫞酸鹽/（膽堿+肌酸）［Cit/(Cho+Cr)，C/CC］與彌散加權(quán)成像（DWI）中的ADC值對(duì)前列腺癌Gleason評(píng)分的預(yù)估價(jià)值，為前列腺癌的早期診斷、病理分級(jí)、手術(shù)方式及術(shù)后復(fù)發(fā)的監(jiān)測(cè)提供重要的影像學(xué)依據(jù)，進(jìn)而提高患者的生存率及生活質(zhì)量。 方法①回顧性的分析40例經(jīng)超聲引導(dǎo)下穿刺活檢確診為前列腺癌患者的磁共振波譜，分別測(cè)得每例患者興趣區(qū)的C/CC值，在超聲引導(dǎo)下穿刺興趣點(diǎn)，獲得相應(yīng)的Gleason評(píng)分，將C/CC值與穿刺病理的Gleason評(píng)分結(jié)果進(jìn)行對(duì)照，通過(guò)繪制散點(diǎn)圖及Spearman相關(guān)分析探討二者的相關(guān)性，再根據(jù)C/CC值，對(duì)Gleason評(píng)分7組與Gleason評(píng)分≥7組進(jìn)行獨(dú)立樣本t檢驗(yàn)，p0.05視為有顯著統(tǒng)計(jì)學(xué)意義。將每一個(gè)C/CC值與對(duì)應(yīng)的Gleason評(píng)分進(jìn)行線性回歸分析。②回顧性分析40例經(jīng)超聲引導(dǎo)下穿刺活檢確診為前列腺癌患者的DWI圖像，分別測(cè)得每例患者興趣區(qū)的ADC值，獲得相應(yīng)的Gleason評(píng)分，將ADC值與穿刺病理的Gleason評(píng)分結(jié)果進(jìn)行對(duì)照，通過(guò)Spearman相關(guān)分析探討兩者的相關(guān)性。 結(jié)果①40例患者共計(jì)測(cè)得200個(gè)興趣區(qū)域的C/CC值，每例患者分別計(jì)算其平均C/CC值，經(jīng)Spearman相關(guān)分析，，C/CC值與對(duì)應(yīng)區(qū)的Gleason評(píng)分呈負(fù)相關(guān)（r=-0.698，p=0.01）。Gleason評(píng)分7的高分化癌組的C/CC值平均為0.561±0.108，Gleason評(píng)分≥7的中低分化癌組的C/CC值平均為0.424±0.139，兩組間差異有統(tǒng)計(jì)學(xué)意義(t=3.22，p=0.02)。經(jīng)回歸分析，每個(gè)Gleason評(píng)分與C/CC值存在一定的對(duì)應(yīng)關(guān)系，方差分析結(jié)果（F=54.304，P=0.000）表明回歸方程具有統(tǒng)計(jì)學(xué)意義，決定系數(shù)R2=0.459。②40例患者共計(jì)測(cè)得160個(gè)興趣區(qū)域的ADC值，每例患者分別計(jì)算其平均ADC值，經(jīng)Spearman相關(guān)分析，ADC值與對(duì)應(yīng)區(qū)的Gleason評(píng)分呈負(fù)相關(guān)（r=-0.578，p=0.01）。Gleason評(píng)分7的高分化癌組的ADC值平均為（0.821±0.128）×10-3mm2/s， Gleason評(píng)分≥7的中低分化癌組的ADC值平均為（0.644±0.149）×10-3mm2/s，兩組間差異有統(tǒng)計(jì)學(xué)意義(t=3.12，p=0.01)。 結(jié)論磁共振功能成像中的C/CC值和ADC值均與Gleason評(píng)分呈負(fù)相關(guān)，MRS及DWI對(duì)前列腺癌的評(píng)分有指導(dǎo)意義，可在無(wú)創(chuàng)的方式下用于前列腺癌Gleason評(píng)分的預(yù)估。
[Abstract]:Objective to evaluate the predictive value of citrate / (choline creatine) (citrate / (Cho Cr) C / CC) and diffusion weighted imaging (DWI) in Gleason score of prostate cancer in magnetic resonance spectroscopy (Mrs), which is the early diagnosis and pathological grade of prostate cancer. The method of operation and the monitoring of postoperative recurrence provide important imaging evidence to improve the survival rate and quality of life of patients. Methods 1 the magnetic resonance spectroscopy of 40 patients with prostate cancer diagnosed by ultrasound guided biopsy were retrospectively analyzed. The values of C / CC in each patient's area of interest were measured, and the corresponding Gleason score was obtained under the guidance of ultrasound. The C- / CC value was compared with the Gleason score of puncture pathology, and the correlation between them was discussed by drawing scatter plot and Spearman correlation analysis, and then according to the C- / CC value, Gleason score 7 group and Gleason score 鈮

本文編號(hào)：2068989