体素内不相干运动扩散加权成像在良性脑膜瘤中的初步临床研究

发布时间：2018-01-09 15:01

  本文关键词：体素内不相干运动扩散加权成像在良性脑膜瘤中的初步临床研究　出处：《广州中医药大学》2017年硕士论文　论文类型：学位论文

  更多相关文章： 体素内不相干运动扩散加权成像 磁共振成像 灌注 不同病理类型 良性脑膜瘤

【摘要】：目的:通过体素内不相干运动扩散加权成像(Intravoxel Incoherent Motion Diffusion Weighted Imaging,IVIM-DWI)技术各相关参数(纯扩散系数,slow ADC或D;灌注分数,f;伪扩散系数,fast ADC或D*)在良性脑膜瘤(benign meningioma)中的应用价值,为临床上手术方案的选择及IVIM-DWI脑灌注技术的推广应用提供一定的理论依据。方法:收集2016年2月至2017年1月来我院(广州军区广州总医院)就诊并经手术切除及病理结果最终证实为良性脑膜瘤的20例首诊(未经任何治疗的)患者,均于术前行常规MRI序列、IVIM-MRI序列及增强MRI序列扫描,体素内不相干运动扩散加权成像序列选用16个不同加权b值(范围0～900s/mmm2),并通过采用IVIM-DWI技术经典的双指数模型分别记录此20例良性脑膜瘤肿瘤实质区与对侧正常脑白质区IVIM-DWI各相关参数(纯扩散系数,slow ADC或D;灌注分数,f;伪扩散系数,fast ADC或D*);另外,在单指数模型下单独计算肿瘤实质区与对侧正常脑白质区的表观扩散系数(apparent diffusion coefficient,ADC),采用配对样本t检验分别比较脑膜瘤肿瘤实质区与正常脑白质区的ADC、D、D*、f值,运用SPSS20.0统计学软件对所测得的各个参数数据进行统计学分析(P0.05有统计学意义)。结果:1、单指数模型中,20例良性脑膜瘤患者肿瘤实质区ADC值低于对侧正常脑白质区ADC值,两者比较差异无统计学意义(t=-0.5037,户0.05)。2、双指数模型中,20例良性脑膜瘤患者肿瘤实质区slow ADC值高于对侧正常脑白质区slow ADC值,两者比较差异有统计学意义(t=3.0027,户0.05)。3、双指数模型中,20例良性脑膜瘤患者肿瘤实质区fast ADC值高于对侧正常脑白质区fast ADC值,两者比较差异无统计学意义(t=1.2863,P 0.05)。4、双指数模型中,20例良性脑膜瘤患者肿瘤实质区f值高于正常对侧脑白质区f值,两者比较差异无统计学意义(t=-0.2221,户0.05)。结论:IVIM-MRI作为一种新型的脑肿瘤灌注技术,相对于传统的DWI-MRI来说是一种十分可靠的技术。IVIM双指数模型D值可以准确描述良性脑膜瘤的水分子扩散信息,有助于扩大灌注技术的临床应用范围。
[Abstract]:Objective: through intravoxel incoherent motion diffusion weighted imaging (Intravoxel Incoherent Motion Diffusion Weighted Imaging, IVIM-DWI) of the related parameters (pure technology diffusion coefficient, slow ADC or D; f; perfusion fraction, pseudo diffusion coefficient, fast, ADC or D*) in benign meningioma (benign meningioma) application value, providing a theoretical basis for selection of clinical application on surgical operation and IVIM-DWI perfusion technique. Methods: from February 2016 to January 2017 in our hospital (Genenral Hospital of PLA Guangzhou Military Area) and treatment by surgical resection and pathological findings proved benign meningiomas in 20 cases of first diagnosed (untreated) patients, all the patients underwent routine MRI sequence, IVIM-MRI sequence and enhanced MRI sequence scanning, intravoxel incoherent motion diffusion weighted imaging sequences using 16 different weighted b value (0 ~ 900s/mmm2), and by using IVI The relevant parameters of the 20 cases of benign meningiomas in the tumor and contralateral normal brain white matter IVIM-DWI recorded double exponential model of classic M-DWI technique respectively (pure diffusion coefficient, slow ADC or D; f; perfusion fraction, pseudo diffusion coefficient, fast, ADC or D*); in addition, apparent diffusion coefficient calculation of the tumor parenchyma and contralateral normal brain white matter alone in the single index model under the table (apparent diffusion coefficient, ADC), paired sample t test were compared in parenchyma of meningiomas and normal brain white matter areas ADC, D, D*, F, using SPSS20.0 statistical software for statistical analysis of the measured data of each parameter are (statistically significant P0.05). Results: 1, the single index model, 20 patients with benign meningiomas in the parenchyma of the ADC value is lower than the contralateral normal brain white matter ADC values, there was significant difference between the two groups (t= -0.5037, 0.05.2), the double exponential model, 2 0 cases of patients with benign meningiomas tumor parenchyma slow ADC value is higher than the contralateral normal brain white matter slow ADC value, the difference was statistically significant (t=3.0027, 0.05).3, double exponential model, 20 patients with benign meningiomas in the parenchyma of fast ADC was higher than the contralateral normal brain white matter ADC values fast, no statistical significant difference (t=1.2863 P 0.05).4, double exponential model, parenchyma tumor patients in 20 cases of benign meningiomas f was higher than the normal contralateral cerebral white matter F values, there was significant difference between the two groups (t=-0.2221, 0.05). Conclusion: IVIM-MRI is a brain tumor model the perfusion technique, compared with the traditional DWI-MRI is a very reliable technology.IVIM double exponential model of D value of water molecules can accurately describe the benign meningioma diffusion information, clinical application and contribute to the expansion of perfusion technique.

【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R739.45
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本文编号：1401830