本文選題：三維重建 + 骨密度　； 參考：《南方醫(yī)科大學(xué)》2014年碩士論文

【摘要】：背景 在臨床工作中發(fā)現(xiàn)大量腰腿痛的患者,有些患者甚至非常年輕,以男性多見。但是臨床醫(yī)生對(duì)于這些患者在進(jìn)行體格檢查時(shí)往往只是進(jìn)行一些常規(guī)的檢查,在發(fā)現(xiàn)某些具有陽性意義的體征時(shí)就讓病人去做X線或者CT甚至MRI等影像學(xué)檢查,得出的往往是腰椎椎間盤膨出、突出等診斷。直到患者出現(xiàn)了典型的癥狀甚至出現(xiàn)了骨折等嚴(yán)重的并發(fā)癥的時(shí)候才得到骨質(zhì)疏松癥的確切診斷。這個(gè)時(shí)候既增加了患者的生活負(fù)擔(dān),降低了其生活質(zhì)量,又增加了病人的經(jīng)濟(jì)負(fù)擔(dān)。通過運(yùn)用新的圖像分割方法對(duì)這些病人的腰椎CT圖像逐一分離出每一個(gè)椎體并且讀取椎體模型的CT值最大值、最小值以及平均值后發(fā)現(xiàn),一部分病人的椎體的CT值最小值均為負(fù)值,最低的時(shí)候甚至可以達(dá)到-1024。我們推測(cè)出這些椎體里應(yīng)該含有氣體的成分,并試著找尋椎體里會(huì)含有氣體的原因。通常情況下老年患者會(huì)出現(xiàn)不同程度的腰椎退行性改變,椎體內(nèi)可能存在氣體,但是年輕的患者腰椎并不存在退行性病變,因此我們推測(cè)出年輕患者腰椎可能有其它一些病變,進(jìn)一步調(diào)查發(fā)現(xiàn)患者的親屬存在原發(fā)性骨質(zhì)疏松癥病史。由此我們推測(cè)該患者可能具有原發(fā)性骨質(zhì)疏松癥的某些癥狀如骨密度值減低。 目的 將不同年齡段男女腰腿痛患者腰椎螺旋CT掃描圖像導(dǎo)入三維重建軟件,通過新的圖像分割方法將這些圖像中的腰椎椎體結(jié)構(gòu)逐一分割出來迅速求解出腰椎CT值最大值、最小值以及平均值并探索其變化規(guī)律,并且嘗試探討CT值與骨密度值的關(guān)系。以達(dá)到對(duì)年輕人群進(jìn)行篩查、對(duì)那些癥狀不典型的人群早期診斷、早期治療,減少病人的經(jīng)濟(jì)負(fù)擔(dān)和生活負(fù)擔(dān),降低其致殘率以及并發(fā)癥發(fā)生,提高其生存質(zhì)量的目的。 方法 隨機(jī)采集21-70歲202例腰腿痛病人,按照年齡以每隔10歲為一個(gè)年齡段進(jìn)行分組,每個(gè)年齡段又按照性別再分別分為男女兩組共10組,其中21-30歲年齡段男女各15例,31-40歲年齡段男女各22例,41-50歲年齡段男女各21例,51-60歲年齡段男女各21例,61-70歲年齡段男女各22例,每組男性女性各50塊椎體,共500塊。對(duì)病人進(jìn)行腰椎螺旋CT掃描,CT設(shè)備為美國(guó)通用電氣公司64排螺旋CT掃描儀。CT掃描的參數(shù)為120KV、264MAS,層厚為0.625mm,圖像以512x512像素DICOM格式刻錄至DVD光盤輸出。首先采用新的圖像分割方法對(duì)21-70歲202例腰腿痛病人共500塊椎體通過三維重建軟件將其逐一分離出來,其次求解出每一個(gè)年齡段男性和女性患者的腰椎CT值的最大值、最小值以及平均值并分別進(jìn)行統(tǒng)計(jì)學(xué)分析。 在Windows7Ultimate64bit操作系統(tǒng)下,將CT掃描數(shù)據(jù)導(dǎo)入醫(yī)學(xué)三維重建軟件Mimics14.0。隨后重建出腰椎三維模型,先移除髂骨和骶骨,之后分別將各個(gè)椎體分離并建立相應(yīng)的獨(dú)立的蒙板(Mask)文件,再分離椎體、椎弓根及椎板圍繞行成的閉合空間,接下來進(jìn)行模型輪廓線的計(jì)算、填充Mask中的空洞、運(yùn)用布爾運(yùn)算中的“布爾減”操作將每個(gè)病人的腰椎椎體逐一分割出來。完成后讀取椎體模型的CT值平均值、最大值及最小值。 以SPSS16.0軟件對(duì)實(shí)驗(yàn)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)處理,采用單因素方差分析統(tǒng)計(jì)方法,對(duì)每個(gè)年齡段男女腰腿痛患者的CT值的最大值、最小值以及平均值進(jìn)行比較。當(dāng)讀取的男性和女性不同年齡段組的CT值采用平均值±標(biāo)準(zhǔn)差表示時(shí)我們還比較相同年齡段男女性腰椎CT值平均值以及不同年齡段男性以及女性腰椎CT值平均值。分別對(duì)男性和女性不同年齡組之間患者CT值的最大值、最小值以及平均值進(jìn)行單因素方差分析檢驗(yàn),看其差異是否具有統(tǒng)計(jì)學(xué)意義。若差異有統(tǒng)計(jì)學(xué)意義時(shí)再進(jìn)行組間的多重比較。進(jìn)行組間的多重比較時(shí)先對(duì)各部分?jǐn)?shù)據(jù)進(jìn)行方差齊性檢驗(yàn),方差齊時(shí)采用LSD法、Bonferroni法、SNK法以及Scheffe法。方差不齊時(shí)采用Dunnett's T3法和Dunnett's C法,P0.05認(rèn)為差異有統(tǒng)計(jì)學(xué)意義。 結(jié)果 男性各組CT值平均值比較：進(jìn)行方差齊性檢驗(yàn),得到P=0.629,不拒絕H0,方差齊。方差分析結(jié)果：整體比較5組間差異存在統(tǒng)計(jì)學(xué)意義(P=0.000),需要進(jìn)一步做多重比較。結(jié)果顯示Scheffe法和Bonferroni法結(jié)果一致,即21-30歲年齡組與41-50歲年齡組(P=0.000)、21-30歲年齡組和51-60歲年齡組(P=0.000)、21-30歲年齡組和61-70歲年齡組(P=0.000)、31-40歲年齡組和41-50歲年齡組(P值分別為0.002和0.001)、31-40歲年齡組和51-60歲年齡組(P=0.000)、31-40歲年齡組和61-70歲年齡組(P=0.000)之間差異有統(tǒng)計(jì)學(xué)意義。LSD法結(jié)果顯示除了上述組別的差異具有統(tǒng)計(jì)學(xué)意義以外,41-50歲年齡組和61-70歲年齡組差異具有統(tǒng)計(jì)學(xué)意義(P=0.007)。而SNK法結(jié)果顯示除去21-30歲年齡組與31-40歲年齡組(P=0.070)、41-50歲年齡組與51-60歲年齡組(P=0.099)以及51-60歲年齡組與61-70歲年齡組(P=0.290)差異無統(tǒng)計(jì)學(xué)意義以外,其它組之間差異均有統(tǒng)計(jì)學(xué)意義。通過對(duì)比可知LSD法和SNK法的結(jié)果一致。 男性各組CT值最小值比較：進(jìn)行方差齊性檢驗(yàn),得到P=0.000,拒絕H0,方差不齊。方差分析結(jié)果：多重比較選擇基于方差不齊的多重比較方法Dunnett'sT3和Dunnett's C。Dunnett's T3法：21-30歲年齡組與51-60歲年齡組(P=0.003)、21-30歲年齡組與61-70歲年齡組(P=0.000)、41-50歲年齡組與61-70歲年齡組(P=0.003)以及51-60歲年齡組與61-70歲年齡組(P=0.049)差異存在統(tǒng)計(jì)學(xué)意義,其它各組均無統(tǒng)計(jì)學(xué)意義。Dunnett's C法：該方法只給出區(qū)間估計(jì)結(jié)果。對(duì)于可信區(qū)間的結(jié)果,若可信區(qū)間不包含0則表示有統(tǒng)計(jì)學(xué)差異,21-30歲年齡組與41-50歲年齡組(0.5317～104.8283)、21-30歲年齡組與51-60歲年齡組(26.4708～167.3692)、21-30歲年齡組與61-70歲年齡組(115.2617～400.0583)、41-50歲年齡組與61-70歲年齡組(54.9861～354.9739)以及51-60歲年齡組與61-70歲年齡組(3.4447-318.0353)差異存在統(tǒng)計(jì)學(xué)意義,其它各組均無統(tǒng)計(jì)學(xué)意義； 男性各組CT值最大值比較：進(jìn)行方差齊性檢驗(yàn),得到P=0.158,不拒絕H0,方差齊。方差分析結(jié)果：整體比較5組間不存在統(tǒng)計(jì)差異(P=0.196)。 女性所有CT值指標(biāo)總體方差均不齊,但整體組間差異具有統(tǒng)計(jì)學(xué)意義,需要進(jìn)一步作多重比較。 女性各組CT值平均值比較：Dunnett's T3法：21-30歲年齡組與51-60歲年齡組(P=0.000)、21-30歲年齡組與61-70歲年齡組(P=0.000)、31-40歲年齡組與51-60歲年齡組(P=0.000)、31-40歲年齡組與61-70歲年齡組(P=0.000)、41-50歲年齡組與51-60歲年齡組(P=0.002)、41-50歲年齡組與61-70歲年齡組(P=0.000)以及51-60歲年齡組與61-70歲年齡組(P=0.000)之間差異存在統(tǒng)計(jì)學(xué)意義,其它各組均無統(tǒng)計(jì)學(xué)意義。Dunnett's C法：對(duì)于可信區(qū)間的結(jié)果,若可信區(qū)間不包含0則表示有統(tǒng)計(jì)學(xué)差異,21-30歲年齡組與51-60歲年齡組(33.4098-108.2318)、21-30歲年齡組與61-70歲年齡組(104.8592～164.9632)、31-40歲年齡組與51-60歲年齡組(38.0154-119.9654)、31-40歲年齡組和61-70歲年齡組(108.6934～177.4682)、41-50歲年齡組和51-60歲年齡組(14.1076-90.6100)、41-50歲年齡組和61-70歲年齡組(85.3575～147.5409)、51-60歲年齡組和61-70歲年齡組(25.7676～102.4132)之間差異存在統(tǒng)計(jì)學(xué)意義,其它各組均無統(tǒng)計(jì)學(xué)意義。 女性各組CT值最小值比較：Dunnett's T3法：21-30歲年齡組與41-50歲年齡組(P=0.034)、21-30歲年齡組與51-60歲年齡組(P=0.001)、21-30歲年齡組與61-70歲年齡組(P=0.000)、31-40歲年齡組與51-60歲年齡組(P=0.016)、31-40歲年齡組與61-70歲年齡組(P=0.002)、41-50歲年齡組與51-60歲年齡組(P=0.017)以及41-50歲年齡組與61-70歲年齡組(P=0.001)之間差異存在統(tǒng)計(jì)學(xué)意義,其它各組均無統(tǒng)計(jì)學(xué)意義。Dunnett's C法：對(duì)于可信區(qū)間的結(jié)果,若可信區(qū)間不包含0則表示有統(tǒng)計(jì)學(xué)差異,21-30歲年齡組與41-50歲年齡組(1.6356-53.2044)、21-30歲年齡組與51-60歲年齡組(43.0432～213.3568)、21-30歲年齡組與61-70歲年齡組(61.0564～197.1836)、31-40歲年齡組與51-60歲年齡組(15.3406～218.2594)、31-40歲與61-70歲年齡組(30.1131～205.3269)、41-50歲年齡組和51-60歲年齡組(13.8947～187.6653)、41-50歲年齡組和61-70歲年齡組(31.4859-171.9141)之間差異存在統(tǒng)計(jì)學(xué)意義,其它各組均無統(tǒng)計(jì)學(xué)意義。 女性各組CT值最大值比較：Dunnett's T3法：21-30歲年齡組與61-70歲年齡組(P=0.003)、31-40歲年齡組與61-70歲年齡組(P=0.000)、41-50歲年齡組與61-70歲年齡組(P=0.000)以及51-60歲年齡組與61-70歲年齡組(P=0.017)之間差異存在統(tǒng)計(jì)學(xué)意義,其它各組均無統(tǒng)計(jì)學(xué)意義。Dunnett's C法：對(duì)于可信區(qū)間的結(jié)果,若可信區(qū)間不包含0則表示有統(tǒng)計(jì)學(xué)差異,21-30歲年齡組與61-70歲年齡組(9.1578～66.5622)、31-40歲年齡組與61-70歲年齡組(28.2892～83.5508)、41-50歲年齡組與61-70歲年齡組(26.3460～83.6540)、51-60歲年齡組與61-70歲年齡組(4.4480～67.9120)之間差異存在統(tǒng)計(jì)學(xué)意義,其它各組均無統(tǒng)計(jì)學(xué)意義。 當(dāng)讀取的男性和女性不同年齡段組的CT值采用平均值±標(biāo)準(zhǔn)差表示時(shí),對(duì)相同年齡段男性和女性腰椎CT值平均值進(jìn)行比較,結(jié)果顯示：除去21-30歲年齡組以及51-60歲年齡組以外,其它組間差異均具有統(tǒng)計(jì)學(xué)意義。 分別對(duì)男性以及女性不同年齡段腰椎CT值平均值進(jìn)行比較,結(jié)果顯示：男性組：21-30歲組、31-40歲組分別與41歲以上各年齡組以及41-50歲組與61-70歲組比較差異有統(tǒng)計(jì)學(xué)意義；女性組：21-30歲組、31-40歲組、41-50歲組分別與51歲以上各年齡組以及51-60歲組與61-70歲組比較差異有統(tǒng)計(jì)學(xué)意義。 結(jié)論 1.CT值平均值與骨密度值具有相關(guān)性。 2.通過新的圖像分割方法可以快速準(zhǔn)確獲取任意感興趣區(qū)域的腰椎CT值。 3.腰椎CT值平均值隨著年齡增加而降低。
[Abstract]:background
In clinical work, a large number of patients with lumbago and leg pain are found, some are even very young and are often seen in men. But the clinicians often take some routine examinations for the physical examination of these patients. In the case of certain positive signs, the patients are given X-ray or CT, even MRI, and other imaging examinations, It is often the diagnosis of lumbar disc herniation, protrusion, etc. until the patient has a typical symptom and even serious complications such as fracture, the exact diagnosis of osteoporosis is obtained. This time not only increases the burden of life, reduces the quality of life, but also increases the financial burden of the patient. A new image segmentation method is used to separate each vertebra CT image from each vertebra one by one and read the maximum value, minimum and average of the CT value of the vertebral body model. The minimum value of the CT value of a part of the vertebral body is negative. At the lowest point, we can even reach -1024. that we speculate that these vertebral bodies should contain There is a gas component, and try to find the cause of the gas in the vertebral body. In general, the elderly patients may have different degrees of lumbar degeneration, there may be gas in the vertebral body, but there is no degenerative disease in the young patients. Therefore, we speculate that there may be some other lesions in the young patients' lumbar vertebrae. The step survey found that the patients' relatives had a history of primary osteoporosis, and we speculated that the patient may have some symptoms of primary osteoporosis such as reduced bone density.
objective
The lumbar spiral CT scan image of lumbar and leg pain of men and women of different ages is introduced into the 3D reconstruction software. The lumbar vertebra structure in these images is divided by a new image segmentation method. The maximum value, minimum value and average value of lumbar CT value are solved and the change law is explored, and the CT value and bone density are explored. To achieve the purpose of screening young people, early diagnosis of those with untypical symptoms, early treatment, reducing the patient's financial burden and living burden, reducing the rate of disability and complications, and improving the quality of life.
Method
202 cases of lumbar and leg pain at the age of 21-70 years were randomly collected and divided into groups according to age at 10 years of age. Each age group was divided into two groups of men and women, including 15 men and women in 21-30 years of age, 22 in 31-40 years of age, 21 in 41-50 years of age, and 21 for men and women of 51-60 age groups. 22 cases of men and women at the age of 61-70, each group of male and female 50 vertebral bodies, with a total of 500 vertebrae. The patients were scanned for spiral CT. The CT device was 120KV, 264MAS, and 0.625mm in the 64 row CT scanner of the American Ge Corp. The image was recorded in DICOM format of 512x512 pixels to the output of DVD disc. First, a new map was used. A total of 500 vertebral bodies, 202 cases of lumbar and leg pain 21-70 years old, were separated by three-dimensional reconstruction software, and the maximum value, minimum and average value of the CT value of each age group of male and female patients were calculated, and the statistical analysis was performed respectively.
Under the Windows7Ultimate64bit operating system, the CT scanning data was introduced into the medical 3D reconstruction software Mimics14.0. and then the 3D model of the lumbar spine was reconstructed. The ilium and the sacrum were removed first. Then the vertebral bodies were separated and the corresponding independent mask (Mask) files were separated and separated from the vertebral body, the pedicle and the vertebral lamina, and the closed space around the vertebral body. Then the model contour is calculated, the holes in the Mask are filled and the lumbar vertebrae of each patient are divided by the Boolean operation. The average value, maximum and minimum of the CT value of the model of the vertebral body are completed.
The experimental data were statistically processed with SPSS16.0 software, and a single factor variance analysis was used to compare the maximum, minimum and average value of the CT value of the men and women with low back and leg pain in each age group. When the CT value of the men and women in different age groups was expressed with the average standard deviation of the standard deviation, we were also compared. The mean value of the CT value of the male and female lumbar vertebrae in the same age group and the mean value of the CT value of the male and female lumbar vertebrae in different age groups were examined by single factor analysis of variance for the maximum, minimum and average value of the CT value of the men and women of different age groups, and the difference was statistically significant. If there was a statistical difference, the difference was statistically significant. The multiple comparison between groups was carried out. When the multiple comparison between groups was carried out, the variance homogeneity test was performed on all parts of the data. LSD, Bonferroni, SNK and Scheffe were used when the variance was homogeneous. The Dunnett's T3 method and Dunnett's C method were used when the variance was inhomogeneous, and P0.05 believed that the difference had the significance of unified planning.
Result
The average value of CT in male groups was compared: P=0.629, H0, Fang Chaqi. Analysis of variance: the difference between the 5 groups was statistically significant (P=0.000), and multiple comparisons were needed. The results showed that the results of Scheffe and Bonferroni were the same, that is, the age group of 21-30 years and the age group of 41-50 years (P=0). .000), 21-30 year old age group and 51-60 year age group (P=0.000), 21-30 year old age group and 61-70 year age group (P=0.000), 31-40 year old age group and 41-50 year old group (P value 0.002 and 0.001 respectively), 31-40 year old age group and 51-60 year old age group (P=0.000), the difference between 31-40 age group and 61-70 age group (P=0.000) is statistically significant.LSD knot The results showed that the differences of the 41-50 year old age group and the 61-70 year age group were statistically significant (P=0.007). The results of the SNK method showed that the 21-30 year old age group and the 31-40 year old age group (P=0.070), the 41-50 year old group and the 51-60 year old group (P=0.099), the 51-60 year old age group and the 61-70 year old age group were found. There was no significant difference between the two groups (P=0.290). The difference between the other groups was statistically significant. By contrast, the results of LSD and SNK were consistent.
The minimum value of CT values in male groups: a homogeneity test of variance, P=0.000, rejection of H0, variance of variance. Variance analysis results: multiple comparison selection based on multiple comparison method based on variance inhomogeneous Dunnett'sT3 and Dunnett's C.Dunnett's T3 method: 21-30 year old age group and 51-60 year old age group (P=0.003), 21-30 year old age group and 61-70 year old age Group (P=0.000), 41-50 year old age group and 61-70 year age group (P=0.003), 51-60 year old age group and 61-70 year age group (P=0.049) have statistical significance, other groups have no statistical significance.Dunnett's C method: this method only gives interval estimation results. For the result of the confidence interval, if the confidence interval does not contain 0, there are statistics. The 21-30 year old age group and 41-50 year old age group (0.5317 to 104.8283), 21-30 year old age group and 51-60 age group (26.4708 to 167.3692), 21-30 year old age group and 61-70 year old age group (115.2617 ~ 400.0583), 41-50 years age group and age group, age group and age group (3.4447-318.035 3) the difference was statistically significant, but no significant difference was found in the other groups.
The maximum value of CT values in male groups was compared: the homogeneity test of variance, P=0.158, no refusal of H0, Fang Chaqi. Results of variance analysis: there was no statistical difference between the 5 groups (P=0.196).
The overall variance of all CT values of females was not uniform, but the difference between the overall groups was statistically significant. Further multiple comparisons were needed.
The average value of CT values in female groups: Dunnett's T3: 21-30 year old age group and 51-60 year age group (P=0.000), 21-30 year old age group and 61-70 year age group (P=0.000), 31-40 year old age group and 51-60 year age group (P=0.000), 31-40 year old age group and 61-70 year age group (P= 0), 41-50 years age group and 51-60 year age group (P=0.002), 41-50 year old. There was significant difference between the age group and the age group of 61-70 years (P=0.000), 51-60 year old age group and 61-70 year old age group (P=0.000), and there was no statistical significance.Dunnett's C method in the other groups. For the results of the confidence interval, if the confidence interval did not contain 0, there were statistical differences, 21-30 year old age group and 51-60 year old group (33.4098- 108.2318) 21-30 years old age group and 61-70 year old age group (104.8592 ~ 164.9632), 31-40 year old age group and 51-60 year age group (38.0154-119.9654), 31-40 age group and 61-70 year old age group (108.6934 ~ 177.4682), 41-50 age group and 51-60 age group (14.1076-90.6100), age group and age group. The difference was statistically significant between the -60 age group and the 61-70 year old group (25.7676 to 102.4132), but no significant difference was found in the other groups.
The minimum value comparison of CT values in female groups: Dunnett's T3: 21-30 year old age group and 41-50 year age group (P=0.034), 21-30 year old age group and 51-60 year age group (P=0.001), 21-30 year old age group and 61-70 year age group (P=0.000), 31-40 year old age group and 51-60 year age group (P= 0.016), 31-40 years age group and 61-70 year age group (P=0.002), 41-50 year old. There was significant difference between the age group and the age group of 51-60 years (P=0.017), 41-50 year old age group and 61-70 year old age group (P=0.001), and there was no statistical significance.Dunnett's C method in the other groups. For the results of the confidence interval, if the confidence interval did not contain 0, there were statistical differences, 21-30 year old age group and 41-50 year old group (1.6356-5 3.2044) 21-30 years old age group and 51-60 year old age group (43.0432 ~ 213.3568), 21-30 year old age group and 61-70 year age group (61.0564 ~ 197.1836), 31-40 years old age group and 51-60 age group (15.3406 ~ 218.2594). The difference between age group and 61-70 year old age group (31.4859-171.9141) was statistically significant, and no significant difference was found in other groups.
The maximum value comparison of CT values in female groups: Dunnett's T3 method: 21-30 year old age group and 61-70 year age group (P=0.003), 31-40 year old age group and 61-70 year age group (P=0.000), 41-50 year old age group and 61-70 age group (P=0.000), 51-60 year old age group and 61-70 age group (P=0.017), and the other groups have no significant difference. Statistical significance.Dunnett's C method: for the results of the confidence interval, if the confidence interval does not contain 0 statistical differences, 21-30 year old age group and 61-70 year old age group (9.1578 ~ 66.5622), 31-40 age group and 61-70 age group (28.2892 to 83.5508), 41-50 years old and 61-70 years of age group (26.3460 ~ 83.6540), the age of 51-60 There was statistically significant difference between the group and the 61-70 year old group (4.4480 to 67.9120), but no significant difference was found in the other groups.
When the CT values of the men and women in different age groups were represented by average mean standard deviation, the mean values of the CT values of the male and female lumbar vertebrae in the same age group were compared. The results showed that the difference between the 21-30 years old age group and the 51-60 age group was statistically significant.
The average values of lumbar CT values in male and female different age groups were compared. The results showed that: male group: 21-30 year old group, 31-40 year old group compared with 41 years old group, 41-50 year old group and 61-70 year old group, respectively. The female group: 21-30 year old group, 31-40 year old group, 41-50 year old group and all ages above 51 years old, respectively. The difference between the group and the 51-60 year old group was statistically significant compared with that of the 61-70 year old group.
conclusion
The mean value of 1.CT value is correlated with the bone mineral density.
2. through the new image segmentation method, the lumbar CT value of any region of interest can be obtained quickly and accurately.
The average CT value of the lumbar vertebra decreased with the increase of age.
【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R681.5;R816.8

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