本文選題：磁共振成像 + 擴散峰度成像��； 參考：《山西醫(yī)科大學》2014年碩士論文

【摘要】：目的：探討擴散峰度成像(DKI)對腦星形細胞瘤分級的應用價值。 方法：收集自2012年1月至2013年12月,就診于山西醫(yī)科大學第一臨床醫(yī)院腦星形細胞瘤患者共34例(高級別星形細胞瘤21例,低級別星形細胞瘤13例)。所有患者均進行頭顱常規(guī)MRI掃描、增強掃描及DKI掃描,通過工作站對圖像進行后處理,得到平均峰度(mean kurtosis, MK)參數(shù)圖、平均彌散(mean diffusion,MD)參數(shù)圖、各向異性分數(shù)(fraction anisotropy,FA)參數(shù)圖,在相應參數(shù)圖中分別測量高低級別腫瘤實質(zhì)及對側(cè)正常腦白質(zhì)的參數(shù)值MK、FA、MD,上述腫瘤實質(zhì)DKI參數(shù)與對側(cè)正常腦白質(zhì)相應參數(shù)值進行標準化分別得到相應標準化參數(shù)值MK'、FA'、MD'(標準化方法及公式參見材料與方法第三部分),高級別與低級別星形細胞瘤患者腫瘤實質(zhì)區(qū)的所有DKI參數(shù)值比較,采用Mann-Whitney-Wilcoxon檢驗(P0.05有統(tǒng)計學意義),并繪制鑒別高低級別星形細胞瘤分級有統(tǒng)計學意義的參數(shù)值的ROC曲線,判斷AUC大小。 結(jié)果：①高級別星形細胞瘤組的腫瘤實質(zhì)MK值比低級別星形細胞瘤組的腫瘤實質(zhì)MK值明顯升高(P=0.020),臨界值為0.54,MK值靈敏度及特異度分別是76.1%和84.6%,AUC為0.886；②未進行標準化的MD、FA值在兩組星形細胞瘤中差異不明顯,無統(tǒng)計學意義(P0.05)；③標準化值MK'、FA'、MD'在高低級別兩組腫瘤中差別較大,有統(tǒng)計學意義(MK'的P=0.024,FA'的P=0.033,MD'的P=0.031),MK'臨界值為0.50,其靈敏度及特異度分別是85.7%和76.9%,AUC為0.897,FA'值臨界值為0.62,其靈敏度及特異度分別為71.4%和69.2%,AUC為0.762,MD'值臨界值為1.54,其靈敏度及特異度分別為71.4%和69.2%,AUC為0.788。 結(jié)論：高、低級別星形細胞瘤的擴散峰度參數(shù)差異具有統(tǒng)計學意義,能更好對高級別、低級別星形細胞瘤進行分級,因此可用于術(shù)前腦星形細胞瘤分級診斷。
[Abstract]:Objective: to evaluate the value of DKI in grading astrocytoma. Methods: from January 2012 to December 2013, 34 cases of astrocytoma (21 cases of high grade astrocytoma and 13 cases of low grade astrocytoma) in the first Clinical Hospital of Shanxi Medical University were collected. All the patients underwent routine MRI scan, enhanced scan and DKI scan. The mean kurtosissis (MK) parameter map, the mean diffusion-MDM parameter map and the anisotropic fractional fraction anisotropy parameter map were obtained by workstation post-processing. The parameters of high and low grade tumor and contralateral normal white matter were measured in the corresponding parameter map. The DKI parameters of tumor parenchyma and the corresponding parameter value of contralateral normal white matter were standardized respectively. The value of MK / FAA Md (standardized methods and formulas see materials and methods part III, comparison of all DKI parameters in the tumor parenchyma region of high and low grade astrocytomas, Mann-Whitney-Wilcoxon test (P0.05) was used to determine the size of AUC, and the ROC curve was drawn to distinguish the parameter value of high and low grade astrocytoma. Results the MK value of tumor parenchyma in the high-grade astrocytoma group was significantly higher than that in the low-grade astrocytoma group. The critical value of MK value was 0.54mK, the sensitivity and specificity were 76.1% and 84.6%, respectively. The MK value of the tumor parenchyma was not standardized. There was no significant difference in MDFA between the two groups. There was no statistically significant difference between the two groups in the difference between high and low grade tumors. The critical value of P0. 031 MK' of P0. 033 MD' is 0. 50, its sensitivity and specificity are 85. 7% and 76. 9% respectively. The critical value of FA' is 0. 897. The sensitivity and specificity are 71. 4% and 69. 2% respectively. The critical value of MD' is 1. 54, and its sensitivity and specificity are 0. 762. The AUC of 71.4% and 69.2% were 0.788. Conclusion: the diffusive kurtosis parameters of high and low grade astrocytoma are statistically significant and can be used for the diagnosis of high grade and low grade astrocytoma before operation.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R739.41;R445.2

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相關(guān)期刊論文 前1條

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