MR功能成像在神经胶质瘤放疗中的应用

发布时间：2018-05-18 13:44

本文选题：胶质瘤 + 弥散张量成像　；参考：《清华大学》2014年硕士论文

【摘要】：胶质瘤是最常见的颅脑恶性肿瘤,而放射治疗是治疗胶质瘤的重要手段之一。目前所有的胶质瘤放疗方案都是临床医生根据基于CT影像,或是CT和MR影像的SE序列融合确定的,然而中枢神经系统中很多的重要结构或病理状态是上述两种影像无法分辨的。近年来出现的弥散张量成像(Diffusion Tensor Imaging,DTI)以及在其基础上发展起来的脑白质纤维束成像技术(Fiber Tractography,FT)等多种磁共振功能成像技术使得我们对神经系统的正常结构及病理状态的研究深入到更微观的水平。通过对磁共振功能成像信息的利用结合放射治疗现有的技术,本文的研究内容主要包括了以下三个方面:应用FA值和FA比率鉴别胶质瘤细胞对瘤周纤维束的侵润。经过分别对高级别和低级别胶质瘤的肿瘤中心及瘤周纤维的FA值以及FA比率进行比较,认为FA值无助于对瘤周纤维肿瘤浸润的鉴别。应用DWI影像和ADC值辅助肿瘤靶区勾画对放疗策略的影响。通过应用ADC-map信息和DWI影像辅助高级别胶质瘤病例的临床靶区(CTV)的勾画。应用这些信息辅助勾画将会使CTV体积下降,从而改变整个胶质瘤放疗的策略。应用DTI影像及其信息辅助勾画神经核团区域用于保护脑功能。通过应用FA灰度图、FT追踪信息和图像处理技术辅助勾画神经干细胞(Neural Stem Cell)丰富的两个区域:室管膜下区(subventricular zone,SVZ)海马颗粒齿状回下层(subgranular zone,SGZ),用于病患接受放疗时更好地保护记忆、情感等认知功能。最后作者对本文已完成的工作进行了阐述和总结,并对未来的研究方向做出了预期。
[Abstract]:Glioma is the most common craniocerebral malignant tumor, and radiotherapy is one of the most important methods in the treatment of glioma. At present, all radiotherapy schemes for glioma are determined by clinicians based on CT images or SE sequence fusion of CT and Mr images. However, many important structures or pathological states in the central nervous system are indistinguishable between the two images. In recent years, diffusion Zhang Liang imaging and diffusion Zhang Liang imaging (DTI), and the white matter fiber bundle imaging technology developed on the basis of DTI, have made us understand the normal structure and pathological state of the nervous system. The study went deeper into the micro-level. Through the use of magnetic resonance imaging information combined with the existing technology of radiotherapy, the main contents of this study include the following three aspects: the application of FA value and FA ratio to identify the invasion of glioma cells to the peri-tumor fiber bundle. The FA value and FA ratio of tumor center and peri-tumor fibers in high grade and low grade gliomas were compared respectively. It was concluded that FA value was not helpful in differentiating tumor infiltration around tumor. DWI images and ADC values were used to assist the tumor target delineation on the impact of radiotherapy strategy. ADC-map information and DWI images were used to aid the delineation of the clinical target area of high grade glioma cases. Using this information to aid in sketching will reduce the volume of CTV and change the overall radiotherapy strategy for gliomas. To protect brain function, DTI images and its information were used to delineate the area of neuronucleus. Two abundant areas of neural Stem (neural Stem cell) were delineated by means of FA grayscale map and FT tracing information and image processing techniques. The subventricular zone of subventricular zonetin (SVZ) was used to better protect the memory of patients after radiotherapy. Cognitive function such as emotion. Finally, the author expounds and summarizes the work done in this paper, and expects the future research direction.
【学位授予单位】：清华大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.41;R445.2

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