磁共振扩散张量成像联合波谱成像用于前列腺癌诊断效能的研究

发布时间：2018-04-29 07:10

本文选题：前列腺癌 + 扩散张量成像　；参考：《重庆医科大学》2014年硕士论文

【摘要】：目的：探讨3.0T核磁共振扩散张量成像（DTI）与三维氢质子波谱成像（3D-1H-MRS）联合应用于前列腺癌（PCa）的诊断价值。方法：45例临床上高度怀疑的PCa患者同时行DTI、3D-1H-MRS检查，，对照病理学结果，分别观察平均表观扩散系数（ADC）图、部分各向异性（FA）图、MRS波谱图及扩散张量示踪成像（DTT）图的变化；分别定量分析外周带（PZ）、中央区（CG）癌区和非癌区的ADC值、FA值、（胆碱+肌酐）/枸橼酸盐（CC/C）值的差异。通过逻辑回归构建诊断模型，分别对比分析ADC、FA、DTI、MRS、“DTI联合MRS”诊断外周带及中央区癌的受试者工作特征曲线（ROC）下面积（AUC），并计算DTI、MRS、“DTI和MRS”、“DTI或MRS”的敏感度、特异度、阳性预测值、阴性预测值。结果：38例患者顺利通过检查并获得可分析图像。PCa的ADC图多呈低/稍低信号，FA图多呈高/稍高信号，FA彩图多呈不规则扭曲的异常色彩，DTT图上纤维束明显紊乱、并癌区纤维局部连续性中断或消失；PCa的Cho波峰不同程度抬高，Cit波峰不同程度降低或未见显示。无论PZ或CG，癌区的ADC值均显著低于非癌区（P＜0.01），癌区的FA、CC/C值均显著高于非癌区（P＜0.01，P＜0.05）。在PZ，“DTI联合MRS”的AUC显著高于单独应用DTI、MRS（P＜0.01）；在CG，“DTI联合MRS”的AUC显著高于单独的DTI（P＜0.01），与MRS无显著差异（P＞0.05）。“DTI和MRS”在PZ、CG均获得最高特异度，显著高于单独的DTI、MRS（P＜0.05）；“DTI或MRS”均获得最高敏感度，在PZ显著高于单独的MRS（P＜0.01），在CG显著高于单独的DTI（P＜0.01）。结论：DTI联合3D-1H-MRS较单独的DTI、3D-1H-MRS有助于提高PCa的诊断效能。
[Abstract]:Objective: to evaluate the diagnostic value of 3.0T diffusion Zhang Liang DTI and 3D-1H-MRS in the diagnosis of prostate cancer. Methods 45 highly suspected PCa patients were examined by DTI 3D-1H-MRS, and the mean apparent diffusion coefficient (ADCC), partial anisotropy (MA) and diffusion Zhang Liang tracer imaging (DTT) were observed respectively. The difference of ADC value and FA value (choline creatinine / citrate CCR) was analyzed quantitatively in the peripheral zone (PZG), the central region (CGG) and the non-cancerous area (C / C), respectively. The diagnostic model was constructed by logical regression, and the sensitivity and specificity of DTI MRS, DTI and MRS, DTI or MRS were calculated by comparing and analyzing the area under the operating characteristic curve of peripheral zone and central area cancer, "DTI combined with MRS". Positive predictive value, negative predictive value. Results in 38 patients, the ADC images of analyzable images. PCA showed low / slightly low signal signals. Most of them showed high / slightly high signal signals, and most of them showed irregular and distorted abnormal colors. The fiber bundles on the images were obviously disordered. In addition, the local continuity of the fibers in the cancer area was interrupted or disappeared. The Cho peak of PCA was elevated to different degrees, and the peak of the Cho wave was decreased or not shown. No matter PZ or CG, the ADC value in the cancer area was significantly lower than that in the non-cancerous area (P < 0.01), and the CC-C value in the cancer area was significantly higher than that in the non-cancerous area (P < 0.01 P < 0.05). The AUC of "DTI combined with MRS" was significantly higher than that of MRS alone (P < 0.01), and the AUC of "DTI combined with MRS" was significantly higher than that of MRS (P > 0.05). "DTI and MRS" had the highest specificity in PZG. The highest sensitivity was obtained in "DTI or MRS", which was significantly higher in PZ than in single MRS(P < 0.01, and in CG was significantly higher than that of DTI(P < 0.01 in CG. Conclusion compared with DTI 3D-1 H-Mrs alone, the diagnostic efficiency of PCa can be improved by using the combination of 3D-1H-MRS and 7% DTI.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2;R737.25

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