双指数扩散加权成像对急性白血病化疗后腰椎骨髓的初步研究

发布时间：2018-05-08 21:15

本文选题：急性白血病 + 双指数扩散加权成像　；参考：《山西医科大学》2014年硕士论文

【摘要】：目的对正常志愿者、急性白血病治疗后骨髓未缓解患者(non-remission, NR)、急性白血病治疗后骨髓完全缓解患者(complete remission, CR)腰椎行双指数扩散加权成像及b值等于500s/mm2的单指数扩散加权成像扫描,通过对双指数扩散加权成像获得各参数及ADCsoo值的比较,研究双指数扩散加权成像评估急性白血病(acute leukemia, AL)患者化治疗后腰椎骨髓状态的能力,初步探讨双指数扩散加权成像在AL疗效评价中的应用价值。方法对10位正常志愿者、8例急性白血病NR患者、8例急性白血病CR患者行GE1.5T腰椎矢状位b值等于500s/mm2的单指数DWI及双指数模型扩散加权扫描(b=0、500、800、1000、1500、1800、2000、2500s/mm2),分别测量多个腰椎椎体骨髓ADC500、ADCslow、 ADCfast、f值。正常志愿者10例(50个椎体),急性白血病NR患者8例(40个椎体)、急性白血病CR患者8例(40个椎体)。1、对正常志愿者组、急性白血病NR组、急性白血病CR组的ADC50o值做组间比较；2、对正常志愿者组、NR组、CR组组内的单指数ADC500值与ADCslow值两两比较；3、对正常志愿者组、NR组、CR组的双指数模型ADCslow、ADCfast、f值做组间比较；组间计量资料比较采用方差分析,组内两两比较采用两独立样本t检验。结果(1)正常志愿者、急性白血病NR患者、急性白血病CR组间单指数ADCsoo值差异有统计学意义,正常志愿者与NR组间差异有统计学意义(p0.05),正常志愿者与CR组间差异有统计学意义(p0.05),NR组与CR组间差异有统计学意义(p0.05)(2)正常志愿者、急性白血病NR患者、急性白血病CR组内ADC500、ADCslow差异均有统计学意义(p0.05)(3)正常志愿者、急性白血病NR患者、急性白血病CR组间ADCslow差异无统计学差异,正常志愿者组与NR组间p=0.040.05,差异有统计学意义,正常组与CR组间p=0.8990.05,差异无统计学意义,NR组与CR组间p=0.0390.05,差异有统计学意义；三组间ADCfast值差异具有统计学意义,正常志愿者组与NR组间p=0.1860.05,差异无统计学意义,正常组与CR组间p=0.0760.05,差异无统计学意义,NR组与CR组间p=0.0040.05,差异有统计学意义；三组间f值差异具有统计学意义,正常志愿者组与NR组间p=0.0000.05,差异有统计学意义,正常组与CR组间p=0.0000.05,差异有统计学意义,NR组与CR组间p=0.2050.05,差异无统计学意义。结论(1)骨髓扩散加权扫描图像质量能满足诊断、测量要求；(2)单指数ADC5oo值能为急性白血病的治疗监测提供有价值的信息,ADCslow值较单指数ADC5oo能更好的反映骨髓肿瘤细胞数量信息；(3)ADCslow、ADCfast、f值对急性白血病的疗效评价可以提供参考信息,双指数扩散加权成像扫描获得的参数对于综合反映正常志愿者、急性白血病未缓解患者及急性白血病完全缓解患者骨髓的生理状态具有价值,但其病理生理学基础尚需扩大样本量进一步研究。
[Abstract]:Objective to perform double index diffusion weighted imaging (DWI) and single exponential diffusion weighted imaging (b) of lumbar vertebrae in normal volunteers, non-remissions (NRV) and complete remissions (CRs) of bone marrow after acute leukemia treatment. By comparing the parameters and ADCsoo values obtained by double exponential diffusion weighted imaging, we studied the ability of double exponential diffusion weighted imaging to evaluate the bone marrow status of lumbar vertebrae after treatment with acute leukemia. To discuss the application value of double exponential diffusion weighted imaging in evaluating the curative effect of AL. Methods 10 normal volunteers and 8 CR patients with acute leukemia were examined with single index DWI of sagittal position b of GE1.5T lumbar vertebrae equal to 500s/mm2, and diffusion weighted double exponential model with diffusion-weighted scanning. The bone marrow ADC500ADCslow-ADCD value of multiple lumbar vertebrae was measured. There were 10 normal volunteers (50 vertebral bodies), 8 acute leukemia NR patients (40 vertebral bodies) and 8 acute leukemia CR patients (40 vertebral bodies). The ADC50o value of CR group was compared between two groups. The single index ADC500 value and ADCslow value of CR group in NR group of normal volunteers were compared with that of ADCslow group, and the double-index model ADCslow-ADDCfastf value of NR group in normal volunteers group was compared among groups. ANOVA was used to compare the measurement data among groups, and two independent samples t test were used to compare the two groups. Results (1) there was significant difference in single index ADCsoo between normal volunteers, NR patients with acute leukemia and CR patients with acute leukemia. There was significant difference between normal volunteers and NR group (p 0.05). There was significant difference between normal volunteers and CR group (P 0.05). There was no significant difference in ADCslow between the acute leukemia CR group and the acute leukemia CR group, but there was a significant difference between the normal volunteers and NR group (p 0.040.05, P < 0.05), and there was no significant difference between the acute leukemia CR group and the acute leukemia CR group. There was no significant difference between normal group and CR group (p 0.0390.05), the difference between three groups was statistically significant, and there was no significant difference between normal volunteers group and NR group (p 0.1860.05), there was no significant difference between NR group and NR group. There was no significant difference between normal group and CR group, there was significant difference between NR group and CR group, and there was significant difference in f value among three groups, and between normal volunteer group and NR group, the difference was statistically significant. The difference between normal group and CR group was statistically significant. There was no significant difference between NR group and CR group. Conclusion 1) the quality of bone marrow diffusion-weighted scanning can be used for diagnosis. The value of single index ADC5oo can provide valuable information for monitoring the treatment of acute leukemia. Compared with single index ADC5oo, it can better reflect the number of bone marrow tumor cells and can provide reference information for the evaluation of the curative effect of acute leukemia. The parameters obtained by double exponential diffusion weighted imaging are valuable to reflect the physiological state of bone marrow in normal volunteers, patients with acute leukemia without remission and patients with complete remission of acute leukemia. But the pathophysiological basis needs to be further studied.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R733.71;R445.1

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