本文選題：磁共振成像 + 動(dòng)脈自旋標(biāo)記��； 參考：《安徽醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討體素內(nèi)不相干運(yùn)動(dòng)與動(dòng)脈自旋標(biāo)記技術(shù)對(duì)膠質(zhì)瘤術(shù)前分級(jí)的價(jià)值。方法:選取經(jīng)手術(shù)病理證實(shí)為膠質(zhì)瘤患者31例,所有患者檢查前均未行任何治療,其中女性患者13例,男性患者18例,年齡26~74歲,平均年齡為52.6歲,低級(jí)別膠質(zhì)瘤12例,高級(jí)別膠質(zhì)瘤19例。所有患者術(shù)前均行常規(guī)磁共振、3D-ASL及IVIM掃描,將所得原始數(shù)據(jù)經(jīng)軟件處理獲得CBF圖、D*圖及D圖,選取感興趣區(qū),計(jì)算相應(yīng)的參數(shù)值。所有參數(shù)值采用SPSS軟件進(jìn)行分析,用兩獨(dú)立樣本t檢驗(yàn)比較高、低級(jí)別膠質(zhì)瘤組間的各個(gè)參數(shù)值,P0.05為具有統(tǒng)計(jì)學(xué)意義。利用ROC曲線獲得各個(gè)參數(shù)的最佳閾值、敏感性及特異性,并聯(lián)合篩檢3D-ASL與IVIM兩種成像方法的最佳指標(biāo),獲得敏感性及特異性。結(jié)果:1.高級(jí)別膠質(zhì)瘤組的腫瘤CBF值、r CBF值(103.89±27.00ml/min·100g、4.28±0.63)分別高于低級(jí)別膠質(zhì)瘤組的CBF值、r CBF值(63.96±22.17ml/min·100g、2.72±0.84),差異有統(tǒng)計(jì)學(xué)意義(P0.05);高級(jí)別膠質(zhì)瘤組的腫瘤D*值、r D*值(3.82±0.60mm~2/s、1.95±0.30)分別高于低級(jí)別膠質(zhì)瘤組的D*值、r D*值(2.54±0.50mm~2/s、1.28±0.14),D值、r D值(0.58±0.12mm~2/s、2.40±0.49)分別低于低級(jí)別膠質(zhì)瘤組的D值、r D值(0.75±0.12mm~2/s、3.11±0.42),差異均有統(tǒng)計(jì)學(xué)意義(P0.05);2.利用ROC曲線分析,腫瘤CBF值的曲線下面積為0.879,最佳閾值為79.24ml/min·100g,敏感性、特異性為84.2%、83.3%;r CBF值的曲線下面積為0.917,最佳閾值為2.85,其敏感性、特異性為100%、83.3%;腫瘤D*、D、r D*和r D值的曲線下面積分別為0.925、0.846、0.956和0.882,最佳閾值分別為2.95mm~2/s、0.63mm~2/s、1.40、2.95,敏感性、特異性為94.7%、83.3%和91.7%、73.3%和94.7%、91.7%和75%、94.7%;3.3D-ASL聯(lián)合IVIM成像對(duì)膠質(zhì)瘤進(jìn)行術(shù)前分級(jí)的敏感性及特異性分別為100%、91.7%。結(jié)論:1.CBF、D*、D值及r CBF、r D*、r D值在高、低級(jí)別膠質(zhì)瘤之間差異存在統(tǒng)計(jì)學(xué)意義,可用于術(shù)前對(duì)膠質(zhì)瘤進(jìn)行分級(jí),且r CBF、r D*、r D值優(yōu)于CBF、D*、D值;2.單個(gè)功能成像技術(shù)可用于膠質(zhì)瘤進(jìn)行術(shù)前分級(jí),但其敏感性及特異性欠佳,3D-ASL聯(lián)合IVIM成像可提高膠質(zhì)瘤術(shù)前分級(jí)的敏感性及特異性。
[Abstract]:Objective: to investigate the value of voxel incoherent motion and arterial spin labeling in preoperative grading of gliomas.Methods: 31 cases of glioma proved by operation and pathology were selected. All the patients were not treated before examination. Among them, 13 cases were female, 18 cases were male, the average age was 52.6 years old, 12 cases were low grade glioma.19 cases of high grade glioma.All the patients underwent conventional MRI 3D-ASL and IVIM scanning before operation. The original data were processed by software to obtain the CBF map D * and D map. The region of interest was selected and the corresponding parameter values were calculated.All the parameter values were analyzed by SPSS software. The t test of two independent samples was relatively high, and the value of each parameter between the low grade glioma group was statistically significant (P0.05).The optimum threshold value, sensitivity and specificity of each parameter were obtained by using ROC curve, and the best indexes of 3D-ASL and IVIM imaging methods were screened together to obtain the sensitivity and specificity.The result is 1: 1.By ROC curve analysis, the area under the curve of tumor CBF value was 0.879, the optimum threshold was 79.24ml/min 100g, the sensitivity, the area under the curve with specificity of 84.2and 83.3r CBF was 0.917, and the optimum threshold was 2.85.Conclusion: 1. There is statistical difference between the D value of CBFN D and the value of r CBFN D in high and low grade gliomas, which can be used to grade gliomas before operation, and the value of r CBFN r D is better than that of CBFN D and D value.Single functional imaging technique can be used to grade gliomas before operation, but the sensitivity and specificity of 3D-ASL combined with IVIM imaging can improve the sensitivity and specificity of preoperative grading of gliomas.
【學(xué)位授予單位】：安徽醫(yī)科大學(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

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