本文選題：動(dòng)態(tài)對(duì)比增強(qiáng)磁共振　切入點(diǎn)：高級(jí)別膠質(zhì)瘤　出處：《青島大學(xué)》2017年碩士論文

【摘要】：目的:探討動(dòng)態(tài)對(duì)比增強(qiáng)磁共振成像(dynamic contrast-enhanced MRI,DCE-MRI)在腦膠質(zhì)瘤分級(jí)中的應(yīng)用,并對(duì)血流動(dòng)力學(xué)雙室模型Extended Tofts Linear的復(fù)測性(reproducibility)進(jìn)行研究。材料與方法:收集我院2014年11月至2017年2月術(shù)前行DCE-MRI和增強(qiáng)MRI檢查、術(shù)后經(jīng)病理證實(shí)的腦膠質(zhì)瘤35例,其中高級(jí)別膠質(zhì)瘤23例(男:女=12:11;平均年齡47歲),低級(jí)別膠質(zhì)瘤12例(男:女=4:8;平均年齡52歲)。通過血流動(dòng)力學(xué)雙室模型對(duì)各組數(shù)據(jù)定量分析,獲取腫瘤實(shí)性成分及瘤周區(qū)(1cm內(nèi)水腫區(qū)或鄰近腦實(shí)質(zhì))的血流動(dòng)力學(xué)參數(shù):轉(zhuǎn)運(yùn)系數(shù)-Ktrans、血管外細(xì)胞外間隙對(duì)比劑的容積分?jǐn)?shù)-Ve、血管內(nèi)對(duì)比劑的容積分?jǐn)?shù)-Vp、血液從血管外細(xì)胞外間隙(EES)滲回血管的速率-Kep。通過統(tǒng)計(jì)軟件分析,對(duì)比各參數(shù)在高、低級(jí)別膠質(zhì)瘤實(shí)性成分及瘤周區(qū)是否存在統(tǒng)計(jì)學(xué)差異。并通過兩名高年資的放射科醫(yī)生單獨(dú)、分批次應(yīng)用Extend Tofts Linear模型對(duì)DCE-MRI圖像進(jìn)行血管滲透性定量分析,分別比較兩組各參數(shù)在高、低級(jí)別膠質(zhì)瘤瘤體中是否存在統(tǒng)計(jì)學(xué)差異,由此分析后處理模型的復(fù)測性。結(jié)果:高、低級(jí)別膠質(zhì)瘤腫瘤實(shí)性成分的Ktrans值、Ve值、Vp值、Kep值差異有統(tǒng)計(jì)學(xué)意義(P0.05)。高、低級(jí)別膠質(zhì)瘤瘤周區(qū)Ktrans值、Ve值、Vp值、Kep值差異無統(tǒng)計(jì)學(xué)意義(P0.05)。測量1、測量2兩組高、低級(jí)別膠質(zhì)瘤瘤體的Ktrans值、Ve值及Vp值差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。測量1、測量2兩組Ktrans值、Ve值及Vp值可重復(fù)性比較的組內(nèi)相關(guān)系數(shù)(ICC)值分別為0.93、0.809、0.592,均大于0.4。結(jié)論:通過定量分析瘤體及瘤周區(qū)的Ktrans值、Ve值、Vp值、Kep值,可為高、低級(jí)別膠質(zhì)瘤的鑒別診斷提供定量依據(jù)。且血流動(dòng)力學(xué)雙室模型Extended Tofts Linear在腦膠質(zhì)瘤DCE-MRI血管滲透性定量分析具有很好的復(fù)測性。
[Abstract]:Objective: to investigate the application of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in the classification of gliomas. Materials and methods: from November 2014 to February 2017, 35 cases of glioma were examined by DCE-MRI and enhanced MRI. 23 cases of high grade gliomas (male: female 12: 11; mean age 47 years old) and 12 cases of low grade gliomas (male: female 4: 8; mean age 52 years old). The hemodynamic parameters of the solid components of the tumor and the edema area in the surrounding area of 1 cm or adjacent brain parenchyma) were obtained: transport coefficient -Ktrans, volume fraction of extracellular extracellular contrast agent -Vee, volume fraction of intravascular contrast agent -Vp, blood from. The rate of extravascular osmotic osmosis of EES was analyzed by statistical software. The parameters were compared in high and low grade gliomas and whether there were statistical differences in the solid components and surrounding areas. Two radiologists with high seniority were used to analyze the vascular permeability of DCE-MRI images in batches using Extend Tofts Linear model. The parameters of the two groups in the high and low grade glioma tumor were compared whether there were statistical differences, so as to analyze the repeatability of the post-processing model. There were significant differences in Ktrans value and V _ p value of solid components of low grade gliomas (P < 0.05). There was no significant difference in Ktrans value and V _ p value and V _ p value between low grade gliomas and low grade gliomas (P < 0.01). There were significant differences in Ktrans value and VP value in low grade gliomas (P < 0. 05). The correlation coefficient was 0. 93 / 0. 809 / 0. 592in the two groups, respectively. Conclusion: the Ktrans value and V p value repeatability of the two groups were more than 0. 42.Conclusion: by determining the value of Vp, the correlation coefficient is more than 0. 41.Conclusion: both of the two groups are more than 0. 592% (P < 0. 05). The Ktrans value and V _ p value and V _ p value of the tumor and its surrounding area were analyzed quantitatively. It can provide quantitative basis for differential diagnosis of high and low grade gliomas, and Extended Tofts Linear, a two-compartmental hemodynamic model, has good reproducibility in quantitative analysis of DCE-MRI vascular permeability in gliomas.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R445.2;R739.41

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 葉佳;呂晉浩;趙瑞峰;;磁共振灌注成像在腦膠質(zhì)瘤分級(jí)方面的研究進(jìn)展[J];中華臨床醫(yī)師雜志(電子版);2017年07期

2 何永躍;陳禮剛;;膠質(zhì)瘤免疫治療與血腦屏障[J];國際神經(jīng)病學(xué)神經(jīng)外科學(xué)雜志;2017年01期

3 劉亞虎;梁新強(qiáng);梁亮;陳曉武;杜成利;;3.0T磁共振灌注加權(quán)成像在高級(jí)別膠質(zhì)瘤和單發(fā)腦轉(zhuǎn)移瘤中的鑒別診斷價(jià)值[J];微創(chuàng)醫(yī)學(xué);2017年01期

4 張俊峰;劉恒;陳曉;張偉國;;膠質(zhì)瘤及腫瘤微血管DCE-MRI臨床應(yīng)用及研究進(jìn)展[J];國際醫(yī)學(xué)放射學(xué)雜志;2016年04期

5 許立功;吳爽;張景峰;阮凌翔;;腫瘤血管生成擬態(tài)的影像學(xué)新進(jìn)展[J];中國醫(yī)學(xué)影像學(xué)雜志;2016年03期

6 Jing Zhong;Yan Chen;Liang-Jing Wang;;Emerging molecular basis of hematogenous metastasis in gastric cancer[J];World Journal of Gastroenterology;2016年08期

7 張穎;牛廣明;韓曉東;郭冬玲;苗燕平;白雪菲;吳瓊;吳慧;高陽;;磁共振灌注成像對(duì)腦內(nèi)占位性病變鑒別診斷的價(jià)值[J];內(nèi)蒙古醫(yī)科大學(xué)學(xué)報(bào);2016年01期

8 趙明;付曠;郭麗麗;張鐵成;周麗;趙薈;張晶;;定量動(dòng)態(tài)增強(qiáng)MRI在腦高低級(jí)別膠質(zhì)瘤術(shù)前病理分級(jí)中的應(yīng)用研究[J];中國實(shí)驗(yàn)診斷學(xué);2016年01期

9 李曉夫;高穎;韓忠麗;;腦膠質(zhì)瘤腫瘤血管生成的T2加權(quán)增強(qiáng)血管成像評(píng)價(jià)[J];臨床薈萃;2015年09期

10 張微;牛蕾;馬敏閣;周好;劉學(xué)軍;馮衛(wèi)華;隋慶蘭;;DCE-MRI在高、低級(jí)別腦膠質(zhì)瘤及腦膜瘤中的鑒別診斷[J];磁共振成像;2015年08期

相關(guān)博士學(xué)位論文 前5條

1 李曉琴;磁共振動(dòng)態(tài)增強(qiáng)和彌散加權(quán)成像評(píng)估結(jié)腸癌裸鼠皮下移植瘤抗腫瘤治療效果的實(shí)驗(yàn)研究[D];新疆醫(yī)科大學(xué);2016年

2 陳強(qiáng);MIR-124-5P對(duì)LAMB1轉(zhuǎn)錄后調(diào)控作用抑制高級(jí)別膠質(zhì)瘤的生長[D];南方醫(yī)科大學(xué);2014年

3 譚兆華;成人腦膠質(zhì)瘤術(shù)后治療的系統(tǒng)評(píng)價(jià)[D];中南大學(xué);2013年

4 王世勇;惡性神經(jīng)上皮腫瘤的血管生成擬態(tài)及其對(duì)患者預(yù)后的影響分析[D];南方醫(yī)科大學(xué);2013年

5 賈中正;磁共振動(dòng)態(tài)對(duì)比增強(qiáng)成像的兩室模型分析在腦膠質(zhì)瘤的應(yīng)用研究[D];復(fù)旦大學(xué);2012年

相關(guān)碩士學(xué)位論文 前3條

1 曾夢華;體素內(nèi)不相干運(yùn)動(dòng)在膠質(zhì)瘤術(shù)前分級(jí)中的應(yīng)用價(jià)值[D];南昌大學(xué);2016年

2 張強(qiáng);影響低級(jí)別膠質(zhì)瘤復(fù)發(fā)及惡變的多因素分析[D];吉林大學(xué);2016年

3 王偉;256層CT灌注成像在腦星形細(xì)胞瘤中的應(yīng)用價(jià)值[D];西南醫(yī)科大學(xué);2016年

，

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