本文選題：磁共振成像 + 擴散張量成像　； 參考：《寧夏醫(yī)科大學》2017年碩士論文

【摘要】：第一部分3.0T MR DTI在外周帶前列腺癌診斷中的應用價值目的探討擴散張量成像(DTI)對外周帶前列腺癌(PCa)診斷中的應用價值。方法回顧性分析經(jīng)病理證實的65例前列腺疾患,其中25例外周帶PCa患者(惡性組),40例良性前列腺增生(BPH)和/或慢性前列腺炎(CP)患者(良性組),所有患者于穿刺前均行常規(guī)MRI、DWI及DTI掃描。選擇ROI法測量病灶ADC值及FA值。通過ROC的曲線下面積(AUC)值比較ADC值、FA值及兩者聯(lián)合對外周帶PCa的診斷效能,并初步得出ADC值、FA值診斷外周帶PCa的閾值。結(jié)果前列腺外周帶癌區(qū)與非癌區(qū)ADC值和FA值分別為(0.89±0.19)×10~(-3)mm~2/s,0.25±0.05和(1.46±0.23)×10~(-3) mm~2/s,0.17±0.04,兩者差異均有統(tǒng)計學意義(t值分別為10.414和-7.789,P值均0.05)。ADC閾值為1.135×10~(-3) mm~2/s,診斷外周帶PCa敏感度、特異度分別為96.0%和95.0%;FA閾值為0.196,敏感度、特異度分別為96.0%和85.0%。ROC曲線上,ADC值、FA值及兩者聯(lián)合的AUC分別為0.974,0.907和0.990,95%置信區(qū)間分別為0.900~0.998,0.809~0.965和0.926~1.000。結(jié)論DTI評價參數(shù)ADC、FA值均可為外周帶PCa的診斷及鑒別診斷提供重要的信息,兩者結(jié)合對外周帶PCa的診斷效能較單獨使用任意一參數(shù)高。第二部分3.0 MR DTI聯(lián)合DCE-MRI對外周帶前列腺癌的診斷價值目的探討DTI結(jié)合DCE-MRI對外周帶PCa的診斷價值。方法參照第2版前列腺影像報告和數(shù)據(jù)系統(tǒng)(PI-RADSv2)中DCE-MRI應用分類標準,觀察分類所有納入病例的DCE-MRI影像資料。利用ADC、FA值診斷外周帶PCa的診斷閾值,對本文納入的65例患者資料進行轉(zhuǎn)化分類。ADC值"f1.135×10~(-3)mm~2/s、FA值0.196記為陽性,反之記為陰性;ADC值、FA值分類與DCE-MRI分類聯(lián)合:兩兩聯(lián)合,當n(陽性數(shù))"g1時,記為陽性;三者聯(lián)合,當n(陽性數(shù))"g2時,記為陽性,反之記為陰性。通過ROC的方法,運用AUC比較ADC、FA、DCE-MRI分類結(jié)果及聯(lián)合方案對外周帶PCa的診斷效能。結(jié)果ADC、FA、DCE-MRI及ADC+DCE-MRI、FA+DCE-MRI、ADC+FA+DCE-MRI聯(lián)合診斷外周帶PCa的敏感度、特異度分別為96.0、95.0,96.0、85.0,72.0、77.5,96.0、72.5,96.0、62.5,92.0、100.0。AUC分別為0.955、0.905、0.747、0.842、0.793和0.960,95%置信區(qū)間分別為0.873~0.991,0.806~0.964,0.624~0.847,0.731~0.921,0.674~0.883和0.880~0.993。結(jié)論ADC+DCE-MRI較FA+DCE-MRI對外周帶PCa的診斷效能高,ADC+FA+DCE-MRI分類對外周帶PCa的診斷效能最高。
[Abstract]:The value of 3.0T Mr DTI in the diagnosis of peripheral prostate cancer objective to investigate the value of diffusion Zhang Liang imaging (DTI) in the diagnosis of peripheral prostate cancer (PCA). Methods 65 cases of prostate diseases confirmed by pathology were retrospectively analyzed. Twenty-five patients with peripheral PCA (malignant group) had benign prostatic hyperplasia (BPH) and / or chronic prostatitis (CP) (benign group). All patients underwent conventional MRII-DWI and DTI before puncture. ADC and FA values were measured by ROI method. The area under curve (AUC) value of ROC was used to compare the value of ADC and the diagnostic efficiency of peripheral zone PCA, and the threshold value of ADC value and FA value for diagnosing peripheral zone PCA was preliminarily obtained. Results the ADC values and FA values in the peripheral and non-cancerous areas of the prostate were (0.89 鹵0.19) 脳 10 ~ (-3) mm ~ (-3) mm ~ (-2) and (1.46 鹵0.23) 脳 10 ~ (-3) mm ~ (-3) mm ~ (-2) 路s ~ (2) and (1.46 鹵0.23) 脳 10 ~ (-3) mm ~ (-3) mm ~ (2) P, respectively. The ADC threshold was 1.135 脳 10 ~ (-3) mm ~ (-2) / s, and the difference was statistically significant (t = 10.414 and -7.789 P = 1.135 脳 10 ~ (-3) mm ~ (-2) / s, respectively). The specificity was 96.0% and 95.0%, the threshold value of FA was 0.196, the sensitivity, the specificity were 96.0% and 85.0%, respectively, and the AUC of the ADC value and the combination of the two were 0.9000.9980.8090.965 and 0.9261.000, respectively, and the AUC of the combination were 0.9000.9980.8090.965 and 0.9261.000, respectively. Conclusion the ADCF value of DTI evaluation parameters can provide important information for the diagnosis and differential diagnosis of peripheral PCA. The diagnostic efficacy of the two parameters combined with peripheral zone PCA is higher than that of any other parameter alone. Part 2: diagnostic value of 3. 0 Mr DTI combined with DCE-MRI in peripheral prostate cancer objective to explore the diagnostic value of DTI combined with DCE-MRI in peripheral zone PCA. Methods according to the DCE-MRI classification standard in the second edition of prostate imaging report and data system (PI-RADSv2), the DCE-MRI image data of all the patients included in the classification were observed. Using ADCFFA value to diagnose the diagnostic threshold of peripheral PCA, the data of 65 patients included in this paper were classified as positive. The ADC value "f 1.135 脳 10 ~ (-3) mm ~ (-3) was positive, whereas the negative ADC value and DCE-MRI classification were combined with DCE-MRI classification: two combinations, when n (positive number)" g _ 1. When n (positive number) "g 2, it is positive and negative. By means of ROC, AUC was used to compare the classification results of DCE-MRI and the diagnostic efficacy of the combined regimen. Results the sensitivity and specificity of ADC DCE-MRI and ADC DCE-MRIFA DCE-MRI in the diagnosis of peripheral zone PCA were 96.0 ~ 95.095.09.00.85.0 ~ 77.59.596.0 ~ 72.596.56.00.62.56.52.52.0100.AUC were 0.955 / 0.9050.9070.7470.8420.793 and 0.96095% confidence intervals were 0.8730.9930.9930.9930.9940.8060.9640.9640.7310.921 / 0, 0.6740.883 respectively. Conclusion ADC DCE-MRI is more effective than FA DCE-MRI in the diagnosis of peripheral PCA.
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R445.2;R737.25

【參考文獻】

相關(guān)期刊論文 前10條

1 王蕊;高歌;王慧慧;曹敏;王霄英;;評價第二版前列腺影像報告和數(shù)據(jù)系統(tǒng)對前列腺臨床顯著癌的檢出效能[J];中國醫(yī)學影像技術(shù);2016年12期

2 冷曉明;韓曉蕊;趙曼;劉宇;張佳;劉斯?jié)?;IVIM-DWI在前列腺癌與前列腺增生鑒別診斷中的應用價值及其與Gleason評分的相關(guān)性[J];放射學實踐;2016年08期

3 孔曉勤;邢可舟;史浩;;擴散成像技術(shù)在前列腺癌診斷中的研究進展[J];醫(yī)學影像學雜志;2016年03期

4 王紅燕;;動態(tài)增強MRI在前列腺癌診斷中的臨床價值分析[J];深圳中西醫(yī)結(jié)合雜志;2015年24期

5 王倩;房俊芳;王濱;;磁共振擴散張量成像診斷前列腺癌的理論基礎[J];磁共振成像;2015年01期

6 李鵬;劉家趙;陳志強;楊文君;郭玉林;劉嶺嶺;張俊;;3.0T MR擴散加權(quán)成像定量診斷前列腺疾病[J];臨床放射學雜志;2014年04期

7 盧慧敏;夏春華;高斌;;MR波譜分析對前列腺癌Gleason評分的預估價值[J];實用放射學雜志;2014年02期

8 苗華棟;張長萃;張瑩;陳麗娟;;3T磁共振彌散成像及波譜分析在前列腺癌診斷中的價值[J];中國醫(yī)學計算機成像雜志;2013年04期

9 李鵬;楊文君;陳志強;郭玉林;劉云;楊文靜;李燕;杜奕;;動態(tài)增強MRI診斷前列腺中央腺體癌和不同類型前列腺增生[J];中國醫(yī)學影像技術(shù);2013年06期

10 徐正道;張同華;陳建新;胡翼江;蔡惠芳;王兆平;李玉潔;嚴俊;繆惠東;;MRS鑒別外周帶前列腺炎與前列腺癌的初步研究[J];臨床放射學雜志;2013年06期

，

本文編號：2089253