本文選題：惡性骨腫瘤 + 微觀浸潤��； 參考：《青島大學》2013年碩士論文

【摘要】：目的和意義：通過兔VX2惡性骨腫瘤模型的能譜CT與病理對照,探討能譜曲線鑒別惡性骨腫瘤髓內(nèi)微觀浸潤和骨髓水腫方面的應用價值。材料和方法：新西蘭大白兔34只,月齡為2個月左右,性別不限,體重為2、0～3、0kg。對其右側(cè)脛骨近端鉆孔,將1mm×1mm大小腫瘤組織塊腫瘤塊送入髓腔內(nèi),骨蠟封口。4周左右進行常規(guī)CT和能譜CT掃描。處死模型兔,將標本進行固定、脫鈣,切成連續(xù)3mm矢狀斷面,取脛骨最大矢狀斷面進行分區(qū),制備成病理切片。分別將常規(guī)CT和能譜CT圖像進行矢狀位重建,選取與病理切片一致的圖像觀察。在單能量圖像上選取最佳keV。依據(jù)病理切片,分別在腫瘤區(qū)域(A)、移行區(qū)域(B)及正常髓腔區(qū)域(C)放置感興趣區(qū)(ROIs),觀察每組能譜曲線特點,計算每組斜率值。移行區(qū)在病理上為腫瘤微觀浸潤或骨髓腔單純水腫。分別計算出腫瘤微觀浸潤區(qū)(B1)和單純水腫區(qū)(B2)斜率值。能譜曲線斜率計算公式為：斜率=(HU40keV-HU70keV)/(70-40)。結(jié)果：(1)成功制備模型兔并進行CT掃描和病理學檢查23例。(2)23例常規(guī)CT圖像均不能顯示髓腔內(nèi)腫瘤邊界。能譜CTl40key為顯示惡性骨腫瘤最佳單能量。23例140keV單能量圖像中,7例顯示腫瘤邊緣清楚,16例邊緣欠清,22例圖像中可見位置及CT值均介于腫瘤與正常髓腔兩者之間的移行區(qū)。(3)依據(jù)病理切片,移行區(qū)為腫瘤微觀浸潤7例,單純骨髓水腫15例,其中1例能譜CT圖像無顯示移行區(qū)病理結(jié)果為單純骨髓水腫。(4)腫瘤區(qū)域、移行區(qū)域和正常骨髓腔能譜CT曲線隨著單能量增加,其CT值降低,在40keV-70keV之間CT值下降迅速,大于70keV曲線近于平直。(5)移行區(qū)斜率(B)斜率(為7.78±3.40)大于腫瘤大致浸潤區(qū)(A)ROIs斜率(3.7l±2.15)小于正常髓腔(C)斜率(12.88±4.12)(P0.001)。微觀浸潤區(qū)(B1)的斜率(10.874±2.69)大于單純骨髓水腫區(qū)(B2)斜率(5·838±2.11)(P0.001)。結(jié)論：(1)能譜CT圖像質(zhì)量優(yōu)于常規(guī)CT,能夠顯示惡性骨腫瘤邊緣移行區(qū),能譜曲線證實移行區(qū)斜率區(qū)別于腫瘤組織和正常骨髓腔。(2)運用能譜曲線可以鑒別腫瘤微觀浸潤及單純骨髓水腫,腫瘤微觀浸潤斜率大于單純骨髓水腫。
[Abstract]:Objective and significance: to explore the application value of energy dispersive CT (EDS) in differentiating intramedullary microscopic infiltration and bone marrow edema from malignant bone tumor by means of energy dispersive computed tomography (EDS) and pathology in rabbit VX2 malignant bone tumor model. Materials and methods: 34 New Zealand white rabbits were aged about 2 months. At the proximal end of the right tibia, the tumor mass of 1mm 脳 1mm tumor was injected into the medullary cavity, and the bone wax was sealed for about 4 weeks for routine CT and energy dispersive CT scanning. The model rabbits were sacrificed, the specimens were fixed, decalcified, and cut into continuous 3mm sagittal sections. The tibia was divided into the largest sagittal sections and the pathological sections were prepared. Sagittal reconstruction of conventional CT and energy dispersive CT images were performed respectively. The best Kev is selected on the single energy image. According to the pathological section, the region of interest (ROIsa) was placed in the tumor area (An), the transitional area (B) and the normal medullary cavity (C) respectively. The characteristics of each group's energy spectrum curve were observed and the slope values of each group were calculated. The transitional areas were microinfiltrated tumor or simple edema of medullary cavity pathologically. The slope values of B _ 1 and B _ 2 were calculated respectively. The formula for calculating the slope of the energy spectrum curve is as follows: the slope of HU40keV-HU70keV / U / 70keV / 70 / 40g. Results (1) the model rabbits were successfully made and CT scan and pathological examination were performed in 23 cases. The conventional CT images of 23 cases could not show the margin of intramedullary tumor. Energy spectrum CTl40key is the best single energy for displaying malignant bone tumor. In the 140keV single energy image of 23 cases, 7 cases showed clear margin of the tumor and 16 cases with unclear margin. In 22 cases, the visible position and CT value were between the tumor and the normal medullary cavity. Area 3) according to pathological section, There were 7 cases of microscopic tumor infiltration and 15 cases of simple bone marrow edema in the transitional area. In one case, the pathological results of the transitional area were simple bone marrow edema. The CT curve of the transitional area and the normal medullary cavity increased with the increase of single energy. The CT value decreased rapidly between 40kev and 70keV, and the slope (7.78 鹵3.40) was larger than that of the normal medullary cavity (12.88 鹵4.12P0.001), and the slope of the transition area (7.78 鹵3.40) was larger than that of the normal medullary cavity (12.88 鹵4.12p0. 001), which was higher than that of the normal medullary cavity (3.71 鹵2.15), which was higher than that of the normal medullary cavities (7.78 鹵3.40) and larger than that of the normal medullary cavities (3.71 鹵2.15). The slope of microinfiltrating area B1 (10.874 鹵2.69) was higher than that of bone marrow edema (5838 鹵2.11P0.001). Conclusion the image quality of spectral CT is superior to that of conventional CT, and it can display the marginal transitional area of malignant bone tumor. Energy spectrum showed that the slope of transitional area was different from that of tumor tissue and normal medullary cavity. (2) the microcosmic invasion of tumor and simple bone marrow edema could be distinguished by energy spectrum curve. The slope of microscopic invasion of tumor was higher than that of simple bone marrow edema.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R738.1;R730.44

【參考文獻】

相關(guān)期刊論文 前3條

1 梅炯,蔡宣松,楊振燕,俞光榮,郭荻萍;肢體骨肉瘤髓內(nèi)侵襲范圍的術(shù)前判斷[J];癌癥;2001年01期

2 孟悛非,馬玲,陳應明,江波;EPI-DWI-ADC圖對確定惡性骨腫瘤髓內(nèi)浸潤范圍的價值[J];中國CT和MRI雜志;2003年01期

3 李海嘯;胡永成;黃洪超;;MRI在測量惡性骨腫瘤髓內(nèi)浸潤范圍及確定合理截骨平面中的作用[J];中華關(guān)節(jié)外科雜志(電子版);2007年05期

，

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