本文選題：IVIM + f灌注分數(shù)　； 參考：《吉林大學》2014年碩士論文

【摘要】：目的：初步評價IVIM和DKI的參數(shù)在胰腺癌與慢性腫塊型胰腺炎鑒別診斷的臨床應用價值。 材料與方法：2013年7月至2014年3月共有14名經病理證實的胰腺癌患者（男9名，女5名，年齡52～73歲，中位年齡62歲）、9名經病理（n=3）及臨床隨訪（n=6）證實的慢性胰腺炎患者（男4名，女5名，年39～69歲，中位年齡51歲）納入本研究。受試者在3.0T飛利浦磁共振掃描儀上分別接受11個b值的呼吸觸發(fā)IVIM序列掃描，（b值設定為0,25,50,75,100,150，200,300,400,600,800s/mm2），，以及5個b值的呼吸觸發(fā)DKI序列掃描，(b值設定為0，500,1000,1500,2000s/mm2）。應用IVIM模型計算D、f及D*，應用DKI模型計算MD及MK，選取b值0及600擬合計算表觀彌散系數(shù)ADC值。通過方差分析及q檢驗比較各參數(shù)在胰腺癌、慢性胰腺炎及正常胰腺間的差異；采用ROC曲線分析比較IVIM及DKI在診斷及鑒別診斷的價值。 結果：f在胰腺癌、慢性胰腺炎及正常胰腺間均存在顯著統(tǒng)計學差異（8.36±2.34vs13.77±3.22vs25.1±5.8%，P0.01）；D*在胰腺癌和胰腺炎低于正常胰腺（29±8.8/35±6.2vs57.1±7.8×10-3mm2/s，P＜0.05），但在胰腺癌及胰腺炎間無統(tǒng)計學差異（P=0.100）；D在慢性胰腺炎中低于胰腺癌和正常胰腺（0.98±0.15vs1.26±0.19/1.32±0.17×10-3mm2/s，P＜0.05），但在胰腺癌和正常胰腺間無統(tǒng)計學差異（P=0.413）；Mk在胰腺癌、慢性胰腺炎及正常胰腺間均存在顯著統(tǒng)計學差異（0.90±0.056vs0.82±0.034vs0.66±0.15，p0.01）,MD在正常胰腺中明顯高于胰腺癌及慢性胰腺炎（2.30±0.20vs2.06±0.12/2.02±0.13×10-3mm2/s，P＜0.05），但在胰腺癌及慢性胰腺炎間無統(tǒng)計學差異（P=0.418）；ADC值在正常胰腺顯著高于胰腺癌和慢性胰腺炎（1.38±0.24vs1.09±0.19/1.11±0.16×10-3mm2/s，P＜0.01），但在胰腺癌和慢性胰腺炎間無統(tǒng)計學差異（P=0.883）。IVIM的參數(shù)f及DKI的參數(shù)MK的ROC曲線下面積分別為0.92和0.86，兩者間無統(tǒng)計學差異（P=0.532）。 結論：與正常胰腺組織和慢性腫塊型胰腺炎相比，胰腺癌病變區(qū)域f值明顯降低、MK值明顯增高。IVIM模型和DKI模型對胰腺癌和慢性腫塊型胰腺炎的診斷和鑒別診斷具有臨床應用價值。
[Abstract]:Objective: to evaluate the clinical value of IVIM and DKI in the differential diagnosis of pancreatic cancer and chronic mass pancreatitis. Materials and methods: from July 2013 to March 2014, there were 14 pathologically confirmed pancreatic cancer patients (9 males and 5 females, aged 52 to 73 years). Nine patients with chronic pancreatitis (male 4, female 5, aged 3969 years, median age 51 years) confirmed by pathology and clinical follow-up were included in this study. The subjects received 11 b respiratory trigger IVIM sequences on 3.0T Philips magnetic resonance scanner. The, (b values were set to 0 2550V 75100150 200300400600800smm2, and the, (b values of 5 b values for respiratory triggered DKI sequences were set to 0 / 500,000,000,000,000sr / mm2). The DIFs and DKs were calculated by IVIM model, MD and MKs were calculated by DKI model, and the apparent diffusion coefficient ADC values were calculated by fitting b values 0 and 600. Variance analysis and Q test were used to compare the difference of parameters between pancreatic cancer, chronic pancreatitis and normal pancreas, and the value of IVIM and DKI in diagnosis and differential diagnosis were compared by ROC curve analysis. Results there was a significant difference (8.36 鹵2.34vs13.77 鹵3.22vs25.1 鹵5.8mm ~ (0.01) between pancreatic cancer, chronic pancreatitis and normal pancreas (P < 0. 05), but there was no significant difference (P < 0. 05) between pancreatic cancer and pancreatitis (29 鹵8. 8 鹵35 鹵6.2vs57.1 鹵7. 8 脳 10 ~ (-3) mm ~ (2) P < 0. 05). D was lower in chronic pancreatitis than that in normal pancreas (0.98 鹵0.15vs1.26 鹵0.19 鹵1.32 鹵0.17 脳 10 ~ (-3) mm ~ (-2) P < 0. 05), but there was no significant difference between pancreatic cancer and normal pancreas (P < 0. 413). There was significant difference between chronic pancreatitis and normal pancreas (0.90 鹵0.056vs0.82 鹵0.034vs0.66 鹵0.15p0.01). The MD in normal pancreas was significantly higher than that in normal pancreas and chronic pancreatitis (2.30 鹵0.20vs2.06 鹵0.12 鹵2.02 鹵0.13 脳 10 ~ (-3) mm ~ (-2) P < 0. 05), but there was no significant difference between pancreatic cancer and chronic pancreatitis (P _ 0.418). The ADC values in normal pancreas were significantly higher than those in normal pancreas and chronic pancreatitis (1.38 鹵0.24vs1.09 鹵0.19 鹵1.11 鹵0.16 脳 10 ~ (-3) mm ~ (-2) P < 0. 01), but there was no significant difference between pancreatic cancer and chronic pancreatitis (P < 0. 01). The area under the ROC curve of parameters f of IVIM and MK of DKI was 0. 92 and 0. 86, respectively (P0. 532). Conclusion: compared with normal pancreatic tissue and chronic mass pancreatitis, The value of f in the lesion area of pancreatic cancer was significantly decreased. The IVIM model and DKI model were of clinical value in the diagnosis and differential diagnosis of pancreatic cancer and chronic mass pancreatitis.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R735.9;R576

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相關期刊論文 前1條

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