MRI三维重建测量乳房体积的临床研究

发布时间：2018-03-08 16:32

本文选题：核磁共振　切入点：乳房体积　出处：《吉林大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的探讨MRI三维重建测量不同年龄段女性乳房体积及腺体层体积的变化，并初步界定乳房、乳腺体积测量过程中的阈值范围。方法选择2013年2月-2013年11月合计508例患者MRI平扫+增强+弥散检查数据，其中门诊患者245例，住院手术患者263例，均为女性患者，年龄11岁至87岁，平均43.63+10.94岁。患者俯卧位，双乳自然下垂行胸部MRI扫描，扫描范围自锁骨向下至肋下缘，扫描序列包括冠状位T1WI，矢状位T2WI脂肪抑制，扩散加权成像及动态增强扫描。扫描参数：T1加权像，单一横断位，层厚1mm，扫描图像经数字接口传至GE公司图形工作站。以医学数字图像和通讯标准格式DICOM3.0(Digital Imaging and Communications in Medicine)输出、保存。将保存的DICOM格式的图像全部拷贝到分析用计算机，打开Mimics15.0，选择Import Images，选中一名患者的所有MRI图像，导入软件中。在Mimics15.0平台下进行乳房组织的范围选取和三维重建，，先设定三维模型的生成范围为乳房周围的立方体区域，之后调整图像的对比度，使该区域的不同亮度的组织的边界更为清晰，然后通过设定合适的灰度阈值完成对乳房组织的选取，最终通过对全部选定区域的三维计算，生成双侧乳房的三维模型。同理，通过设定合适的灰度阈值完成对乳房中腺体组织的选取，进而生成腺体的三维模型。Mimics提供了直接对三维模型进行体积测量的功能，通过查看乳房和腺体三维模型的属性，便可显示其具体的体积数值。结果 1，随着年龄变大，乳房和腺体的阈值范围呈现先上升后下降的趋势。 2，40-49岁患者进行乳房普查和就诊的比例约占全部患者比例的一半，远远超过了其他年龄段，其次是30-39岁和50-59岁患者。40-49岁年龄段正是女性乳腺癌高发年龄段，这一年龄段女性对自身乳房健康的关注程度远高于其他年龄段。 3，随着年龄增加，乳房体积基本呈增加趋势，而乳腺体积于20-29岁达到高峰，之后呈下降趋势。这说明随着年龄的增加，乳房体积的增加是由于乳房中的脂肪组织增加引起的。 4，随着年龄增加，%FGV（%FGV：absolute fibroglandular volume）在20-29岁达到高峰，之后呈下降趋势，且从20-29岁到30-39岁及40-49岁到50-59岁下降幅度比较大。 5，纵观各个年龄段，不论乳房体积的比较，还是乳房腺体体积的比较，90%以上患者都是右乳大于左乳，且30-39岁、40-49岁、50-59岁三个年龄段患者左右乳房体积大小差异具有统计学意义（p＜0.05）。结论 1，通过508例乳腺疾病患者乳房体积的测量，对阈值的调整会有个基本的范围，确定操作方法及阈值数值，是我们首要的工作； 2，我们应用解剖学对乳房的定义，确定了在MRI下划分乳房区域的问题； 3，整体患者中，通过双乳MRI体积测量，发现90%以上人的右侧乳房大于左侧乳房体积，且30-39岁、40-49岁、50-59岁三个年龄段患者左右乳房体积大小差异具有统计学意义（p＜0.05）； 4，通过508例乳腺核磁的体积测算及年龄段间的对比，我们得到了一个结论：随着年龄的增大、脂肪的堆积，乳房的整体体积是不断增加的，但腺体层在不断缩小。
[Abstract]:objective
Objective to investigate the changes of breast volume and gland volume in different age groups by MRI three-dimensional reconstruction, and to define the threshold range of breast volume measurement.
Method
In February 2013 -2013 year in November a total of 508 cases of the MRI scan + + enhanced diffusion test data, including 245 cases of patients, 263 cases of hospitalized patients were female patients, aged 11 to 87 years old, the average age of 43.63+10.94. The patients in the prone position, the breasts naturally underwent chest MRI scan, scan range from the clavicle down to the costal margin scanning sequence including coronal T1WI, sagittal T2WI fat suppression, diffusion weighted imaging and dynamic contrast-enhanced scan. The scan parameters: T1 weighted images, single cross section, thickness 1mm, scanning image through a digital interface to GE graphics workstation. The standard format of digital medical image and communication DICOM3.0 (Digital Imaging and Communications in Medicine) output, saved. Save the image in DICOM format are copied to the analysis by computer, open the Mimics15.0, select Import Images, select an image of all MRI patients, Into the software. In the range of breast tissue under Mimics15.0 platform selection and 3D reconstruction, 3D model generation range set for the cube area around the breast, after adjusting the contrast of the image, so that the region of different brightness organizational boundaries more clearly, and then by setting the appropriate gray threshold completed the selection of the breast the organization, finally based on the three-dimensional calculation all selected regions, to generate three-dimensional model of bilateral breast. Similarly, by setting a proper threshold to complete the selection of gray glandular tissue in the breast,.Mimics 3D model and generate gland provides direct volume measurement of the function of the three-dimensional model, the 3D model and view the properties of breast glands that can display the specific volume value.
Result
1, as the age became larger, the threshold of the breast and glands increased first and then decreased.
2,40-49 years old patients with breast screening and treatment accounts for about half of all patients, far more than other age groups, followed by the 30-39 and 50-59 year old patients.40-49 years of age is the high incidence of breast cancer in women age, this age women pay attention to their breast health is far higher than other age groups.
3, with the increase of age, the volume of breast basically increased, while the breast volume reached the peak at 20-29 years old. Then it showed a downward trend. This indicates that the increase of breast volume is due to the increase of adipose tissue in the breast as the age increases.
4, with age increasing,%FGV (%FGV:absolute fibroglandular volume) peaked at 20-29 years old, then decreased, and decreased from 20-29 to 30-39 years old, 40-49 to 50-59 years old.
5, in all ages, no matter the comparison of breast volume or breast gland volume, more than 90% of the patients had right breast milk than those of left breast. The difference of size between left and right breast of 30-39 years old, 40-49 years old, 50-59 year old three age group was statistically significant (P < 0.05).
1, through the measurement of breast volume in 508 cases of breast disease, the adjustment of threshold will have a basic range. Determining the operation method and threshold value is our primary task.
2, we apply the definition of the anatomy to the breast, and determine the problem of the division of the breast region under MRI;
3, the overall volume of MRI patients, through the breasts measurement, found that more than 90% people more than the right side of the breast and the left breast volume, 30-39 years old, 40-49 years old, 50-59 years old was statistically significant in three age patients about breast size differences (P < 0.05);
4, through 508 cases of breast NMR volume calculation and age comparison, we got a conclusion: with the increase of age, fat accumulation, the overall volume of breast is increasing, but the gland layer is shrinking.

【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2;R655.8

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