本文選題：磁共振成像 + 擴(kuò)散加權(quán)成像　； 參考：《山西醫(yī)科大學(xué)》2009年碩士論文

【摘要】： 研究背景 磁共振彌散加權(quán)成像已成功應(yīng)用于中樞神經(jīng)系統(tǒng)病變的臨床診斷和相關(guān)病變的基礎(chǔ)研究;而對(duì)于腹部成像,由于呼吸運(yùn)動(dòng)等因素對(duì)圖像質(zhì)量的影響,其應(yīng)用一直受到限制。隨著磁共振技術(shù)的發(fā)展,腹部臟器的彌散成像已經(jīng)成為可能。對(duì)于肝臟,目前的磁共振彌散加權(quán)成像研究多集中在臨床方面,在動(dòng)物方面的實(shí)驗(yàn)研究國(guó)內(nèi)外文獻(xiàn)報(bào)道相對(duì)少見(jiàn),尤其是良性占位性病變。肝炎性假瘤是由于各種致炎因子長(zhǎng)時(shí)間作用而在肝臟內(nèi)形成炎性瘤樣結(jié)節(jié),為一種肝臟少見(jiàn)良性腫瘤,隨著影像醫(yī)學(xué)設(shè)備及技術(shù)的提高,肝炎性假瘤的檢出有上升趨勢(shì)。由于在影像上缺乏特征性,極易誤診為肝癌,因此,進(jìn)一步研究肝炎性假瘤有重要意義。 目的 建立兔肝炎性假瘤模型,研究其在磁共振常規(guī)及DWI中的表現(xiàn),從而探討DWI在肝炎性假瘤診斷中的價(jià)值。 方法 普通家兔(體重2.0～3.0kg,平均體重2.5kg)20只隨機(jī)分為A、B兩組,每組10只,A組為對(duì)照組,B組為實(shí)驗(yàn)組。實(shí)驗(yàn)組家兔在CT導(dǎo)引下經(jīng)皮穿刺到肝臟后,將1.0～1.5ml弗氏佐劑注射到肝臟;對(duì)照組家兔采用同樣的方法,向肝臟注射生理鹽水1.0～1.5ml。兩周后對(duì)A組、B組家兔行肝臟常規(guī)及DWI掃描。掃描完成后,所有動(dòng)物空氣栓塞處死,觀察肝假瘤發(fā)生率和形態(tài),取假瘤標(biāo)本肉眼觀察后送病理做HE染色。分析病理切片結(jié)果并與兩組動(dòng)物的磁共振常規(guī)圖像及DWI對(duì)照研究,通過(guò)軟件處理測(cè)量出ADC與eADC值。使用SPSS13.0軟件包進(jìn)行統(tǒng)計(jì)學(xué)分析,對(duì)照組與實(shí)驗(yàn)組結(jié)果用獨(dú)立樣本t檢驗(yàn),實(shí)驗(yàn)組間結(jié)果采用單因素方差分析及最小顯著差法(LSD)比較。(P0.05差異無(wú)統(tǒng)計(jì)學(xué)意義,P0.05差異有統(tǒng)計(jì)學(xué)意義)。 結(jié)果 1.成功制作了兔肝炎性假瘤模型,成功率為90%,假瘤大小為1.5士0.5cm。 2.比較實(shí)驗(yàn)組兔肝臟病變、對(duì)照組兔肝臟在不同b值下的ADC值、eADC值得出(1) b值取100、300、600時(shí)實(shí)驗(yàn)組瘤灶與對(duì)照組正常肝實(shí)質(zhì)的ADC值均有顯著性差異(P0.05),其ADC值分別為1.87、1.45、1.12; (2) b值取100、300、600時(shí)實(shí)驗(yàn)組瘤灶與對(duì)照組正常肝實(shí)質(zhì)的eADC值均有顯著性差異(P0.05),其eADC值分別為0.160、0.202、0.342; (3) b取100與300、600,300與100、600時(shí)瘤灶的ADC、eADC值均有統(tǒng)計(jì)學(xué)差異(P0.05)。 3.假瘤在DWI圖像上為高信號(hào)。瘤灶的ADC值低于正常肝實(shí)質(zhì),eADC值高于正常肝實(shí)質(zhì);隨b值的升高,ADC值逐漸下降,eADC值逐漸升高。 4.在炎性假瘤的DWI成像中,b值取300-600為最佳。 結(jié)論 CT導(dǎo)引下肝臟穿刺法可以成功建立兔肝臟炎性假瘤動(dòng)物模型;T1WI、T2WI結(jié)合DWI圖像可以更好地顯示肝臟病變,運(yùn)用ADC和eADC指標(biāo)可進(jìn)一步提高診斷的正確率。
[Abstract]:Research background Mr diffusion weighted imaging has been successfully applied to the clinical diagnosis of central nervous system diseases and the basic research of related diseases, but for abdominal imaging, its application has been limited because of the effect of respiratory movement and other factors on the image quality. With the development of magnetic resonance imaging, diffusion imaging of abdominal organs has become possible. For the liver, most of the current studies on diffusion weighted Mr imaging are focused on clinical aspects. Experimental studies in animals are relatively rare at home and abroad, especially in benign space-occupying lesions. Hepatitis pseudotumor is a kind of rare benign tumor in the liver, which is formed by various inflammatory factors for a long time. With the improvement of imaging medical equipment and technology, the detection of hepatitis pseudotumor is on the rise. Due to the lack of characteristic image, it is easy to be misdiagnosed as liver cancer, so it is important to further study hepatitis pseudotumor. Purpose To establish a rabbit model of hepatitis pseudotumor and to study its manifestations in MRI and DWI, and to explore the value of DWI in the diagnosis of hepatitis pseudotumor. Method The average body weight (2.5kg)20) of rabbits (weight 2.0? 3.0 kg) was randomly divided into two groups: group A (n = 10) and control group (n = 10) and group B (n = 10). 1.0~1.5ml Freund's adjuvant was injected into the liver after percutaneous puncture under the guidance of CT in the experimental group and the control group was injected with normal saline 1.0ml (1.5ml) into the liver with the same method. Two weeks later, liver routine and DWI scanning were performed in group A and B rabbits. After scanning, all the animals were killed by air embolization, and the incidence and morphology of hepatic pseudotumor were observed. The results of pathological sections were analyzed and compared with conventional MRI images and DWI of two groups of animals. The values of ADC and eADC were measured by software processing. SPSS13.0 software package was used for statistical analysis. The results of control group and experimental group were analyzed by independent sample t test. There was no significant difference between experimental group and control group by single factor variance analysis and least significant difference method (P 0.05). There was no significant difference between control group and experimental group (P 0.05). Result 1. The rabbit model of hepatitis pseudotumor was successfully made, the success rate was 90%, and the size of pseudotumor was 1.5 鹵0.5 cm. 2. Compared with the experimental group, the ADC value of the control group was worth 1b at different b values. The ADC value of the tumor focus of the experimental group and the normal liver parenchyma of the control group was significantly different from that of the normal hepatic parenchyma of the control group at 100300600. The ADC value of the control group was 1.87 鹵1.45 鹵1.12; There was significant difference in eADC between the tumor focus of the experimental group and the normal hepatic parenchyma of the control group at 100300600. The eADC value of the experimental group was 0.160 鹵0.202 and 0.342, respectively. The ADC values of ADCE were significantly different between 100 and 300600300 and 100600 tumor foci (P < 0.05). 3. Pseudotumor showed high signal intensity on DWI images. The ADC value of tumor focus was lower than that of normal hepatic parenchyma and increased with the increase of b value. 4. In DWI imaging of inflammatory pseudotumor, the best value was 300-600. Conclusion CT-guided liver puncture can be successfully used to establish the animal model of inflammatory pseudotumor of rabbit liver T1WII-T2WI combined with DWI images can better display hepatic lesions. The correct rate of diagnosis can be further improved by using ADC and eADC.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2009
【分類號(hào)】：R-332;R575;R445.2

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