多b值DWI水通道蛋白分子成像在脑星形细胞瘤分级诊断的初步研究

发布时间：2018-03-29 08:32

本文选题：星形细胞瘤　切入点：脑　出处：《山西医科大学》2017年硕士论文

【摘要】：目的:探讨磁共振多b值DWI水通道蛋白分子成像技术在脑星形细胞瘤高低级别鉴别诊断中的价值。方法:筛选2014年4月至2016年7月期间在我院行手术治疗并证实为脑星形细胞瘤的患者总共52例。根据世界卫生组织(world health organization,WHO)2016年中枢神经系统肿瘤的分类标准分为两组,即低级别组(WHO I-II级)24例和高级别组(WHO III-IV级)28例,所有的患者术前均接受颅脑常规MRI扫描、常规DWI扫描及多b值DWI扫描。在GE Adavantage Workstation 4.4工作站进行后处理获得AQP-ADC伪彩图及常规ADC伪彩图,并分别测量肿瘤实质区及对侧正常白质区的AQP-ADC值及常规ADC值。采用独立样本t检验分析高、低级别组肿瘤实质区及对侧正常白质区的AQP-ADC值及常规ADC值是否具有统计学差异,并利用工作者受试特征(receiver operating characteristic,ROC)曲线分析比较肿瘤实质区的AQP-ADC值与常规ADC值对于脑星形细胞瘤分级的诊断能力。结果:(1)高低级别组间对侧正常白质区的AQP-ADC值及常规ADC值无统计学差异(P=0.224,P0.05);(2)高低级别组间肿瘤实质区的AQP-ADC值在高级别组高于低级别组,常规ADC值在高级别组低于低级别组;以上两个参数在高低级别脑星形细胞瘤间有统计学差异(P0.05);(3)脑星形细胞瘤肿瘤实质区的AQP-ADC值、常规ADC值鉴别高低级别的ROC曲线下面积(area under curve,AUC)分别为0.891、0.778,界值分别为0.120、1.012,敏感性及特异性分别为92.3%及74.1%、84.6%及61.5%。结论:(1)应用多b值DWI水通道蛋白分子成像测定的AQP-ADC值可以鉴别高低级别脑星形细胞瘤;(2)AQP-ADC值对脑星形细胞瘤高低级别的鉴别能力高于常规ADC值。
[Abstract]:Objective: to evaluate the value of magnetic resonance multi-b DWI aquaporin molecular imaging in differential diagnosis of astrocytoma. Methods: surgical treatment was performed in our hospital from April 2014 to July 2016 and confirmed. A total of 52 patients with brain astrocytoma were divided into two groups according to the World Health Organization (WHO) 2016 classification criteria for central nervous system tumors. There were 24 cases of I-II grade in low grade group and 28 cases of WHO III-IV grade in high grade group. All the patients received routine craniocerebral MRI scan before operation. General DWI scan and multi-b value DWI scan. AQP-ADC pseudo-color image and conventional ADC pseudo-color picture were obtained by post-processing on GE Adavantage Workstation 4.4 workstation. The AQP-ADC values and routine ADC values of tumor parenchyma area and contralateral normal white matter area were measured respectively. The AQP-ADC value and routine ADC value of tumor parenchyma area and contralateral normal white matter area in low grade group were analyzed by independent t test. The diagnostic ability of AQP-ADC value of tumor parenchymal area and conventional ADC value in grading of brain astrocytoma was analyzed and compared by using the receiver operating characteristic roc curve. Results the AQP-ADC value and routine of normal white matter area in contralateral normal white matter area between high and low grade group were compared with that of routine ADC value. The AQP-ADC value of tumor parenchyma in the high grade group was higher than that in the low grade group, and the AQP-ADC value of the tumor parenchyma area in the high grade group was higher than that in the low grade group. The conventional ADC value in the high grade group was lower than that in the low grade group, and the AQP-ADC value of the tumor parenchyma of the brain astrocytoma was significantly different between the high and low grade astrocytomas. The area under the ROC curve is 0.891g / 0.778, the boundary value is 0.120,1.012, the sensitivity and specificity are 92.3% and 74.1g / 84.6% and 61.5% respectively. Conclusion the AQP-ADC value can be determined by multi-b-value DWI aquaporin molecular imaging. The value of AQP-ADC in differentiating high and low grade astrocytoma was higher than that of conventional ADC in differentiating high and low grade astrocytoma.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R739.4

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