本文選題：磁共振成像 + 擴(kuò)散峰度成像�。� 參考：《山西醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：探討擴(kuò)散峰度成像(DKI)對(duì)腦星形細(xì)胞瘤分級(jí)的應(yīng)用價(jià)值。 方法：收集自2012年1月至2013年12月,就診于山西醫(yī)科大學(xué)第一臨床醫(yī)院腦星形細(xì)胞瘤患者共34例(高級(jí)別星形細(xì)胞瘤21例,低級(jí)別星形細(xì)胞瘤13例)。所有患者均進(jìn)行頭顱常規(guī)MRI掃描、增強(qiáng)掃描及DKI掃描,通過(guò)工作站對(duì)圖像進(jìn)行后處理,得到平均峰度(mean kurtosis, MK)參數(shù)圖、平均彌散(mean diffusion,MD)參數(shù)圖、各向異性分?jǐn)?shù)(fraction anisotropy,FA)參數(shù)圖,在相應(yīng)參數(shù)圖中分別測(cè)量高低級(jí)別腫瘤實(shí)質(zhì)及對(duì)側(cè)正常腦白質(zhì)的參數(shù)值MK、FA、MD,上述腫瘤實(shí)質(zhì)DKI參數(shù)與對(duì)側(cè)正常腦白質(zhì)相應(yīng)參數(shù)值進(jìn)行標(biāo)準(zhǔn)化分別得到相應(yīng)標(biāo)準(zhǔn)化參數(shù)值MK'、FA'、MD'(標(biāo)準(zhǔn)化方法及公式參見(jiàn)材料與方法第三部分),高級(jí)別與低級(jí)別星形細(xì)胞瘤患者腫瘤實(shí)質(zhì)區(qū)的所有DKI參數(shù)值比較,采用Mann-Whitney-Wilcoxon檢驗(yàn)(P0.05有統(tǒng)計(jì)學(xué)意義),并繪制鑒別高低級(jí)別星形細(xì)胞瘤分級(jí)有統(tǒng)計(jì)學(xué)意義的參數(shù)值的ROC曲線,判斷AUC大小。 結(jié)果：①高級(jí)別星形細(xì)胞瘤組的腫瘤實(shí)質(zhì)MK值比低級(jí)別星形細(xì)胞瘤組的腫瘤實(shí)質(zhì)MK值明顯升高(P=0.020),臨界值為0.54,MK值靈敏度及特異度分別是76.1%和84.6%,AUC為0.886；②未進(jìn)行標(biāo)準(zhǔn)化的MD、FA值在兩組星形細(xì)胞瘤中差異不明顯,無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；③標(biāo)準(zhǔn)化值MK'、FA'、MD'在高低級(jí)別兩組腫瘤中差別較大,有統(tǒng)計(jì)學(xué)意義(MK'的P=0.024,FA'的P=0.033,MD'的P=0.031),MK'臨界值為0.50,其靈敏度及特異度分別是85.7%和76.9%,AUC為0.897,FA'值臨界值為0.62,其靈敏度及特異度分別為71.4%和69.2%,AUC為0.762,MD'值臨界值為1.54,其靈敏度及特異度分別為71.4%和69.2%,AUC為0.788。 結(jié)論：高、低級(jí)別星形細(xì)胞瘤的擴(kuò)散峰度參數(shù)差異具有統(tǒng)計(jì)學(xué)意義,能更好對(duì)高級(jí)別、低級(jí)別星形細(xì)胞瘤進(jìn)行分級(jí),因此可用于術(shù)前腦星形細(xì)胞瘤分級(jí)診斷。
[Abstract]:Objective: to evaluate the value of DKI in grading astrocytoma. Methods: from January 2012 to December 2013, 34 cases of astrocytoma (21 cases of high grade astrocytoma and 13 cases of low grade astrocytoma) in the first Clinical Hospital of Shanxi Medical University were collected. All the patients underwent routine MRI scan, enhanced scan and DKI scan. The mean kurtosissis (MK) parameter map, the mean diffusion-MDM parameter map and the anisotropic fractional fraction anisotropy parameter map were obtained by workstation post-processing. The parameters of high and low grade tumor and contralateral normal white matter were measured in the corresponding parameter map. The DKI parameters of tumor parenchyma and the corresponding parameter value of contralateral normal white matter were standardized respectively. The value of MK / FAA Md (standardized methods and formulas see materials and methods part III, comparison of all DKI parameters in the tumor parenchyma region of high and low grade astrocytomas, Mann-Whitney-Wilcoxon test (P0.05) was used to determine the size of AUC, and the ROC curve was drawn to distinguish the parameter value of high and low grade astrocytoma. Results the MK value of tumor parenchyma in the high-grade astrocytoma group was significantly higher than that in the low-grade astrocytoma group. The critical value of MK value was 0.54mK, the sensitivity and specificity were 76.1% and 84.6%, respectively. The MK value of the tumor parenchyma was not standardized. There was no significant difference in MDFA between the two groups. There was no statistically significant difference between the two groups in the difference between high and low grade tumors. The critical value of P0. 031 MK' of P0. 033 MD' is 0. 50, its sensitivity and specificity are 85. 7% and 76. 9% respectively. The critical value of FA' is 0. 897. The sensitivity and specificity are 71. 4% and 69. 2% respectively. The critical value of MD' is 1. 54, and its sensitivity and specificity are 0. 762. The AUC of 71.4% and 69.2% were 0.788. Conclusion: the diffusive kurtosis parameters of high and low grade astrocytoma are statistically significant and can be used for the diagnosis of high grade and low grade astrocytoma before operation.
【學(xué)位授予單位】：山西醫(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)】：R739.41;R445.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 曾丁巳;肖新蘭;;擴(kuò)散峰度成像(DKI)在中樞神經(jīng)系統(tǒng)的應(yīng)用[J];臨床放射學(xué)雜志;2011年09期

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本文編號(hào)：1823464