体素内不相干运动成像（IVIM）监测脑胶质瘤复发和治疗后反应的初步研究

发布时间：2018-05-02 17:28

本文选题：IVIM + 脑胶质瘤　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:探讨磁共振体素内不相干运动成像(intravoxel incoherent motion,IVIM)在监测脑胶质瘤复发和治疗后反应中的应用价值。方法:收集2015年10月至2016年12月术后病理证实为脑胶质瘤且行同步放化疗的患者26例(15例脑胶质瘤复发,11例治疗后反应),在同步放化疗结束2月内行头部常规MRI扫描、增强扫描及多b值弥散加权扫描,通过IVIM序列的单指数及双指数模型,对图像后处理得到standard ADC、slow ADC(D)、fast ADC(D*)、fraction of fast ADC(f)的伪彩图,分别测量病例异常强化区standard ADC值、D值、D*值、f值。采用两样本t检验比较两组各参数值是否存在差异,受试者工作特性曲线(ROC)评估各参数值在监测脑胶质瘤复发和治疗后反应中的效能。结果:(1)复发组的强化病灶standard ADC值(0.852±0.378)低于治疗后反应组(1.27±0.551),差异有统计学意义(P=0.031);复发组的强化病灶D值(0.528±0.228)低于治疗后反应组(0.751±0.203),差异有统计学意义(P=0.017);复发组的强化病灶D*值(2.91±0.62)高于治疗后反应组(2.42±0.34),差异有统计学意义(P=0.025);复发组的强化病灶f值(0.604±0.261)高于治疗后反应组(0.394±0.231),差异有统计学意义(P=0.044)。(2)ROC曲线分析,当standard ADC值、D值曲线下面积分别为0.703、0.788时,其阈值分别为1.166、0.631,敏感性分别为54.5%、81.8%,特异性分别为86.7%、73.3%,D值的诊断效能优于standard ADC值;ROC曲线分析,当D*值、f值曲线下面积分别为0.752、0.758时,诊断阈值分别为2.642、0.693,敏感性分别为66.7%、81.8%,特异性分别为81.8%、66.7%。结论:IVIM可用于监测脑胶质瘤复发和治疗后反应,为脑胶质瘤术后患者的临床治疗提供影像依据。
[Abstract]:Objective: To investigate the value of intravoxel incoherent motion (IVIM) in the monitoring of recurrent and post treatment response to glioma. Methods: 26 patients (15 cases of glioma recurrence, 11 cases of glioma) were collected from October 2015 to December 2016. In February, routine head MRI scan, enhanced scan and multiple B diffusion weighted scan were performed in February, and the single index and double exponential model of IVIM sequence were used to obtain standard ADC, slow ADC (D), fast ADC (D*) and fraction pseudo color images. D value, D* value, F value. The two sample t test was used to compare the difference between the two groups, and the subjects' work characteristic curve (ROC) was used to evaluate the effectiveness of the parameter values in the monitoring of glioma recurrence and post treatment response. Results: (1) the standard ADC value of the enhanced lesion in the recurrent group (0.852 + 0.378) was lower than that in the post treatment group (1.27 + 0.551). Statistical significance (P=0.031); the D value of the enhanced focus (0.528 + 0.228) in the recurrent group was lower than that in the post treatment group (0.751 + 0.203), and the difference was statistically significant (P=0.017); the D* value of the intensive lesion in the recurrent group was higher than that in the post treatment group (2.42 + 0.34), and the difference was statistically significant (P=0.025), and the F value of the intensive focus of the relapse group was higher (0.604 + 0.261). After the treatment (0.394 + 0.231), the difference was statistically significant (P=0.044). (2) ROC curve analysis, when the standard ADC value and the area under the D value curve were 0.703,0.788, the threshold was respectively 1.166,0.631, the sensitivity was 54.5%, 81.8% respectively, the specificity was 86.7%, 73.3%, D value was better than standard ADC value, ROC curve analysis, When the D* value and the area under the F value curve were 0.752,0.758 respectively, the diagnostic threshold was 2.642,0.693 respectively, the sensitivity was 66.7%, the specificity was 81.8% respectively, the specificity was 81.8% respectively. The 66.7%. conclusion: IVIM can be used to monitor the recurrence and post treatment reaction of glioma, and provide the image basis for the clinical treatment of patients with glioma after operation.

【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;R739.41

【参考文献】