扩散峰度成像对高级别胶质瘤与单发脑转移瘤鉴别诊断的研究

发布时间：2018-06-08 20:54

本文选题：扩散峰度成像 + 多参数　；参考：《青海大学》2017年硕士论文

【摘要】：目的探讨磁共振扩散峰度成像(DKI)的多参数值对高级别胶质瘤(HGG)和单发脑转移瘤(SBM)的鉴别能力。方法收集经手术病理证实或临床随访证实的HGG患者19例和SBM患者14例,所有患者治疗前均行常规MRI扫描、DKI扫描及增强扫描。选取感兴趣区(ROI)测定其DKI各参数值,并进行矫正处理后得到各向异性分数(FA)值、平均扩散(MD)值及平均峰度(MK)值。应用独立样本t检验对两组间各参数值进行统计学分析,有统计学意义的参数绘制受试者工作特征曲线(ROC)。结果HGG组实质区及瘤周区的FA值、MD值及MK值分别为0.432±0.130、1.465±0.402、0.652±0.188;0.176±0.047、1.766±0.326、0.565±0.083。SBM组实质区及瘤周区的FA值、MD值及MK值分别为0.383±0.120、1.647±0.332、0.717±0.176;0.142±0.037、2.024±0.221、0.460±0.057。实质区DKI各参数值在两组间的差异均无统计学意义;而瘤周区的FA值、MD值及MK值在两组间的差异有统计学意义(P0.05)。ROC曲线分析显示,瘤周区FA值临界值为0.161时,鉴别两种肿瘤的敏感性为68.4%,特异性为71.4%,曲线下面积为0,722;瘤周区MD临界值为1.910时,其敏感性为73.7%,特异性为71.4%,曲线下面积为0.756;瘤周区MK值临界值为0.516时,其敏感性为84.2%,特异性为85.7%,曲线下面积为0.865。瘤周区的MK值在鉴别两种肿瘤时敏感性、特异性较FA值、MD值更高,且其曲线下面积最大。结论瘤周区的FA值、MD值及MK值对HGG和SBM有良好的鉴别诊断价值,且瘤周区MK值诊断效能最高。
[Abstract]:Objective to investigate the differential value of Mr diffusion kurtosis imaging (DKI) for high grade glioma (HGG) and single metastatic tumor (SBM). Methods 19 cases of HGG and 14 cases of SBM confirmed by operation and pathology or clinical follow-up were collected. All the patients were examined by conventional MRI and enhanced MRI before treatment. The values of DKI parameters were measured by ROI, and the values of anisotropic fractions (FAs), mean diffusivity (MD) and mean kurtosis (MK) were obtained after correction. The independent sample t-test was used to analyze the values of each parameter between the two groups, and the statistically significant parameters were used to draw the operating characteristic curve of the subjects. Results the FA values and MK values of parenchymal and peritumorous areas in HGG group were 0.432 卤0.130 卤1.465 卤0.402 卤0.652 卤0.188 0.176 卤0.047 卤1.766 卤0.3260.65 卤0.083.SBM, the FA values of MD and MK were 0.383 卤0.120 卤1.647 卤0.332W 0.717 卤0.1760.142 卤3772.024 卤0.2210.460 卤0.0577.The values of FA and MK in parenchymal and peritumoral areas were 0.383 卤0.120, 1.647 卤0.332n, 0.717 卤0.1760.142 卤3,72.24 卤0.2210.460 卤0.057, respectively. There was no significant difference in DKI parameters between the two groups, but the difference of FA value and MK value between the two groups was statistically significant (P < 0.05). The critical value of FA value was 0.161. The sensitivity was 68.4%, specificity 71.4, area under curve 0722, critical value of MD 1.910, sensitivity 73.775, specificity 71.4, area under curve 0.756, critical value of MK 0.516. The sensitivity was 84.2 and the specificity was 85.7.The area under the curve was 0.865. The sensitivity and specificity of MK value in the peripheral region of tumor were higher than that of FA value and MD value, and the area under the curve was the largest. Conclusion the FA value and MK value of the tumor zone have good value in differential diagnosis of HGG and SBM, and the value of MK value is the most effective in the diagnosis of HGG and SBM.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R739.41

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