磁共振弥散张量成像在脊髓肿瘤的临床应用研究
发布时间：2018-07-30 07:11
【摘要】：第一部分健康人脊髓磁共振弥散张量成像的初步研究 目的：利用磁共振弥散张量成像(DTI)的方法,对健康志愿者进行脊髓扫描,探讨脊髓DTI扫描技术的临床应用。 方法：对24例健康志愿者(平均年龄34.08±12.63岁)分段进行脊髓DTI扫描,其中颈段、上胸段、下胸段各8例。利用MedINRIA软件对扫描后所得的数据进行分析。根据手动勾勒的感兴趣区(ROI),将脊髓横截面整体纳入ROI范围内。逐个节段计算FA值、ADC值和FT值,计算各节段FT值与该次扫描的最高节段FT值的比值,即FTR。观察健康人脊髓DTI图像及弥散张量纤维束成像(DTT)的图像特点,分析DTI扫描分数各向异性(FA)、表观弥散系数(ADC)、纤维束数量(FT)及纤维束比值(FTR)在不同节段、性别及年龄间的特点。 结果：扫描后计算获得整体脊髓的FA值为0.647±0.065,ADC值为1.175±0.170,FT值为1998±620.9,FTR值为0.789±0.177。DTI图像显示脊髓形态正常,FA图像显示脊髓以蓝色(脊髓纵轴方向)信号为主,ADC图像显示脊髓呈稍低信号,DTT图像显示脊髓纤维走行自然,主要沿脊髓纵轴方向排列。颈段、上胸段、下胸段脊髓间DTI扫描FA值无显著差异(P0.05),ADC值、FT值及FTR之间的差异有统计学意义(P0.05),脊髓各节段间FA值、ADC值、FT值和FTR存在差异(P0.05)。不同性别间脊髓DTI参数无显著差异(P0.05)。年龄(23-58岁)与脊髓DTI各参数值间无直线相关关系(P0.05)。 结论：脊髓DTI及DTT图像能够较好地显示脊髓形态、结构和各向异性信息。脊髓DTI扫描参数值在各节段的之间存在差异,性别与年龄对脊髓DTI扫描各参数无明显影响。DTI扫描能够直观、定量地为脊髓的临床研究提供参考信息。 第二部分磁共振弥散张量成像在脊髓肿瘤的临床应用 目的：利用磁共振弥散张量成像(DTI)的方法,对脊髓肿瘤患者及对照组受检者进行扫描,探讨DTI技术在脊髓肿瘤的临床应用。 方法：分别对20例脊髓肿瘤组患者和20例对照组受检者的相应节段进行脊髓DTI扫描。利用MedINRIA软件对扫描后所得的数据进行分析。根据手动勾勒的感兴趣区(ROI),将脊髓横截面整体纳入ROI范围内。逐层计算FA值、ADC值和FT值,计算脊髓肿瘤组病灶层FT值与病灶上层和病灶下层FT值的比值,以及对照组中层FT值与上层和下层FT值的比值(FTR1、FTR2)。脊髓肿瘤组患者进行McCormik分级、脊髓独立测量(SCIM)评分、美国脊髓损伤协会脊髓残损分级(AIS)和脊髓损伤神经学分类国际标准评分(ISNCSCI),包括评分总分、运动评分、感觉评分。观察脊髓肿瘤患者脊髓DTI图像及弥散张量纤维束成像(DTT)的图像特点,分析脊髓肿瘤的DTI扫描分数各向异性(FA)、表观弥散系数(ADC)、纤维束数量(FT)及纤维束比值(FTR)的特点,分析髓外肿瘤与髓内肿瘤DTI扫描参数的特征,研究脊髓肿瘤DTI扫描参数值与临床评分间的相关性。 结果：扫描后计算获得脊髓肿瘤组受检者脊髓平均FA值为0.607±0.104,ADC值为1.405±0.294,FT值为1746±554.4,FTR2为0.739±0.173,FTR2为0.808±0.198。对照组受检者脊髓的平均FA值为0.649±0.048,ADC值为1.161±0.132,FT值为2005.6±403.8,FTR2值为0.998±0.034,FTR2为1.011±0.049。图像上髓外肿瘤以脊髓受压移位为主要表现；髓内肿瘤相应部位脊髓外形增粗,髓内信号异常。在FA图上,髓外肿瘤患者脊髓以蓝色信号为主,瘤体内呈混杂信号；髓内肿瘤患者脊髓信号混杂。ADC图显示,髓外肿瘤患者脊髓受压部位信号稍高,髓内肿瘤患者脊髓信号呈点片状升高。DTT图上显示,髓外肿瘤生长部位脊髓纤维束受压变形,髓内肿瘤生长部位可见脊髓纤维束结构破坏。脊髓肿瘤组与对照组DTI扫描FA值、ADC值、FT值和FTR之间的差异有统计学意义(P0.05),脊髓肿瘤组病灶上层DTI参数值与对照组比较无明显差异(P0.05),病灶层和病灶下层与对照组比较有明显差异(P0.05)。脊髓肿瘤组各层面的DTI参数值之间存在显著差异(P0.05)。髓外肿瘤与髓内肿瘤患者脊髓的FA值、ADC值、FT值以及FTR之间差异有统计学意义(P0.05)。脊髓肿瘤病灶层的FA值、ADC值、FT值和FTR与患者临床评分除ADC值与AIS分级之间无明显直线相关关系(P0.05)外,其他各参数值与评分值之间均存在直线相关关系(P0.05)。 结论：脊髓肿瘤DTI扫描能够显示脊髓形态、结构及各向异性改变,DTT图像能够显示脊髓纤维束的移位和损伤情况。脊髓肿瘤的DTI扫描参数值出现异常,髓外肿瘤与髓内肿瘤患者脊髓的DTI参数值亦存在差异,脊髓肿瘤DTI扫描的参数值与临床评分所反映的脊髓功能缺失基本一致。DTI扫描参数值能够较好地反映脊髓肿瘤患者的脊髓损伤和神经功能情况。
[Abstract]:Part I preliminary study of diffusion tensor imaging in healthy human spinal cord
Objective: To investigate the clinical application of DTI scanning technique in healthy volunteers by magnetic resonance diffusion tensor imaging (DTI).
Methods: 24 healthy volunteers (the average age of 34.08 + 12.63 years) were divided into the spinal cord DTI scans, including the cervical, upper thoracic and lower thoracic segments in 8 cases. The MedINRIA software was used to analyze the scanned data. The spinal cord cross section was integrated into the ROI range according to the manually outlined region of interest (ROI). The FA value was calculated one by one, ADC. Value and FT value, calculate the ratio of the FT value of each segment to the maximum segment FT of the scan, that is, the image characteristics of the DTI image of the spinal cord and the diffusion tensor fiber beam imaging (DTT) in healthy people, and the analysis of the DTI scan fractional anisotropy (FA), the apparent dispersion coefficient (ADC), the number of fiber bundles (FT) and the fiber bundle ratio (FTR) in different segments, sex and year. The characteristics of the age.
Results: after scanning, the FA value of the whole spinal cord was 0.647 + 0.065, the ADC value was 1.175 + 0.170, the FT value was 1998 + 620.9, the FTR value was 0.789 + 0.177.DTI, the spinal cord was normal, the FA image showed the spinal cord in blue (the longitudinal axis of the spinal cord) signal, the ADC image showed a slightly lower signal in the spinal cord and the DTT image showed the spinal fiber walking self. However, there was no significant difference in the FA value of DTI scan between the cervical segment, the upper thoracic segment and the lower thoracic segment of the spinal cord (P0.05), and the difference between the ADC value, the FT value and the FTR was statistically significant (P0.05). There was a difference between the FA values, ADC values, FT values and FTR (P0.05) between the segments of the spinal cord (P0.05). The age (23-58 years old). There was no linear correlation between DTI values and spinal cord parameters (P0.05).
Conclusion: the DTI and DTT images of spinal cord can better display the morphological, structural and anisotropic information of spinal cord. There is a difference between the parameters of the spinal cord DTI scanning parameters between the segments. There is no obvious influence of sex and age on the parameters of the spinal cord DTI scan, and the.DTI scan can be intuitionistic and provide reference information for the clinical study of spinal cord.
The second part of magnetic resonance diffusion tensor imaging in the clinical application of spinal cord tumors
Objective: to scan the patients of spinal cord tumor and control group by using the method of magnetic resonance diffusion tensor imaging (DTI) to explore the clinical application of DTI in the spinal cord tumor.
Methods: the spinal cord DTI scan was performed on the corresponding segments of 20 patients with spinal cord tumor and 20 control groups. The data were analyzed by MedINRIA software. The spinal cord cross section was integrated into the ROI range according to the manual intramedullary region of interest (ROI). The FA value, ADC value and FT value were calculated by layer by layer, and the spinal swelling was calculated. The ratio of the FT value of the tumor layer to the upper layer and the lower FT value of the lesion, and the ratio of the middle layer FT to the upper and lower FT values (FTR1, FTR2) in the control group. The patients in the spinal cord tumor group were graded by McCormik, independent of the spinal cord (SCIM) score, the spinal cord damage classification (AIS) and the international standard of Neurology for spinal cord injury. Score (ISNCSCI), including score total score, exercise score, sensory score. The characteristics of the spinal cord tumor patients' spinal cord DTI image and diffusion tensor fiber bundle imaging (DTT) were observed, and the DTI scan score anisotropy (FA), apparent diffusion coefficient (ADC), the quantity of fiber bundle (FT) and fiber bundle ratio (FTR) of spinal tumors were analyzed, and the extramedullary tumors were analyzed. And the characteristics of DTI scanning parameters in intramedullary tumors, and to study the correlation between DTI scan parameters and clinical scores.
Results: after scanning, the average FA value of spinal cord was 0.607 + 0.104, ADC value was 1.405 + 0.294, FT value was 1746 + 554.4, FTR2 was 0.739 + 0.173, FTR2 was 0.808 + 0.198. control group, and the average FA value of spinal cord was 0.649 + 0.048, ADC value was 1.161 + 0.132, FT value was 1.405 011 + 0.049. images of extramedullary tumors were mainly manifested by compression of the spinal cord. The spinal cord of the intramedullary tumor was thickened and the intramedullary signal was abnormal. On the FA map, the spinal cord of the patients with extramedullary tumors was mainly blue signal, and the tumor was mixed signal. The intramedullary tumor patients' spinal cord signal mixed.ADC map showed the spinal cord compression of the extramedullary tumor patients. The signal of the location of the spinal cord was slightly higher, and the spinal cord signal in the intramedullary tumor was raised on the.DTT map. The spinal fiber bundles were compressed and the spinal cord fibrous structural damage was seen in the growth parts of the intramedullary tumor. The FA value, the ADC value, the FT value and the FTR between the spinal tumor group and the control group were statistically significant (P0.05), and the spinal cord was statistically significant (P0.05). There was no significant difference in the DTI parameters between the lesions of the myeloid tumor group and the control group (P0.05). The lesion layer and the lower layer of the lesion were significantly different from the control group (P0.05). There was a significant difference between the parameters of the DTI parameters at various levels of the spinal cord tumor group (P0.05). There were differences between the FA value, the ADC value, FT value and FTR between the extramedullary and intramedullary tumor patients. Statistical significance (P0.05). There was a linear correlation between the FA value, ADC value, FT value and FTR of the lesion layer of the spinal cord tumor and the patient's clinical score except the ADC value and the AIS classification (P0.05), and there was a linear correlation between the values of the other parameters and the score values (P0.05).
Conclusion: DTI scan of spinal cord tumor can show morphological, structural and anisotropic changes in spinal cord. DTT images can show the displacement and damage of spinal cord fibers. The DTI scanning parameters of spinal tumors are abnormal, and the parameters of DTI parameters in the spinal cord of extramedullary and intramedullary tumors are also different. The parameters of the DTI scan of spinal tumors and the presence of the spinal cord tumor The score of the spinal cord is basically consistent with that of the.DTI score. It can better reflect the spinal cord injury and neurological function in patients with spinal cord tumors.
【学位授予单位】：第二军医大学
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R739.42;R445.2
本文编号：2154239
[Abstract]:Part I preliminary study of diffusion tensor imaging in healthy human spinal cord
Objective: To investigate the clinical application of DTI scanning technique in healthy volunteers by magnetic resonance diffusion tensor imaging (DTI).
Methods: 24 healthy volunteers (the average age of 34.08 + 12.63 years) were divided into the spinal cord DTI scans, including the cervical, upper thoracic and lower thoracic segments in 8 cases. The MedINRIA software was used to analyze the scanned data. The spinal cord cross section was integrated into the ROI range according to the manually outlined region of interest (ROI). The FA value was calculated one by one, ADC. Value and FT value, calculate the ratio of the FT value of each segment to the maximum segment FT of the scan, that is, the image characteristics of the DTI image of the spinal cord and the diffusion tensor fiber beam imaging (DTT) in healthy people, and the analysis of the DTI scan fractional anisotropy (FA), the apparent dispersion coefficient (ADC), the number of fiber bundles (FT) and the fiber bundle ratio (FTR) in different segments, sex and year. The characteristics of the age.
Results: after scanning, the FA value of the whole spinal cord was 0.647 + 0.065, the ADC value was 1.175 + 0.170, the FT value was 1998 + 620.9, the FTR value was 0.789 + 0.177.DTI, the spinal cord was normal, the FA image showed the spinal cord in blue (the longitudinal axis of the spinal cord) signal, the ADC image showed a slightly lower signal in the spinal cord and the DTT image showed the spinal fiber walking self. However, there was no significant difference in the FA value of DTI scan between the cervical segment, the upper thoracic segment and the lower thoracic segment of the spinal cord (P0.05), and the difference between the ADC value, the FT value and the FTR was statistically significant (P0.05). There was a difference between the FA values, ADC values, FT values and FTR (P0.05) between the segments of the spinal cord (P0.05). The age (23-58 years old). There was no linear correlation between DTI values and spinal cord parameters (P0.05).
Conclusion: the DTI and DTT images of spinal cord can better display the morphological, structural and anisotropic information of spinal cord. There is a difference between the parameters of the spinal cord DTI scanning parameters between the segments. There is no obvious influence of sex and age on the parameters of the spinal cord DTI scan, and the.DTI scan can be intuitionistic and provide reference information for the clinical study of spinal cord.
The second part of magnetic resonance diffusion tensor imaging in the clinical application of spinal cord tumors
Objective: to scan the patients of spinal cord tumor and control group by using the method of magnetic resonance diffusion tensor imaging (DTI) to explore the clinical application of DTI in the spinal cord tumor.
Methods: the spinal cord DTI scan was performed on the corresponding segments of 20 patients with spinal cord tumor and 20 control groups. The data were analyzed by MedINRIA software. The spinal cord cross section was integrated into the ROI range according to the manual intramedullary region of interest (ROI). The FA value, ADC value and FT value were calculated by layer by layer, and the spinal swelling was calculated. The ratio of the FT value of the tumor layer to the upper layer and the lower FT value of the lesion, and the ratio of the middle layer FT to the upper and lower FT values (FTR1, FTR2) in the control group. The patients in the spinal cord tumor group were graded by McCormik, independent of the spinal cord (SCIM) score, the spinal cord damage classification (AIS) and the international standard of Neurology for spinal cord injury. Score (ISNCSCI), including score total score, exercise score, sensory score. The characteristics of the spinal cord tumor patients' spinal cord DTI image and diffusion tensor fiber bundle imaging (DTT) were observed, and the DTI scan score anisotropy (FA), apparent diffusion coefficient (ADC), the quantity of fiber bundle (FT) and fiber bundle ratio (FTR) of spinal tumors were analyzed, and the extramedullary tumors were analyzed. And the characteristics of DTI scanning parameters in intramedullary tumors, and to study the correlation between DTI scan parameters and clinical scores.
Results: after scanning, the average FA value of spinal cord was 0.607 + 0.104, ADC value was 1.405 + 0.294, FT value was 1746 + 554.4, FTR2 was 0.739 + 0.173, FTR2 was 0.808 + 0.198. control group, and the average FA value of spinal cord was 0.649 + 0.048, ADC value was 1.161 + 0.132, FT value was 1.405 011 + 0.049. images of extramedullary tumors were mainly manifested by compression of the spinal cord. The spinal cord of the intramedullary tumor was thickened and the intramedullary signal was abnormal. On the FA map, the spinal cord of the patients with extramedullary tumors was mainly blue signal, and the tumor was mixed signal. The intramedullary tumor patients' spinal cord signal mixed.ADC map showed the spinal cord compression of the extramedullary tumor patients. The signal of the location of the spinal cord was slightly higher, and the spinal cord signal in the intramedullary tumor was raised on the.DTT map. The spinal fiber bundles were compressed and the spinal cord fibrous structural damage was seen in the growth parts of the intramedullary tumor. The FA value, the ADC value, the FT value and the FTR between the spinal tumor group and the control group were statistically significant (P0.05), and the spinal cord was statistically significant (P0.05). There was no significant difference in the DTI parameters between the lesions of the myeloid tumor group and the control group (P0.05). The lesion layer and the lower layer of the lesion were significantly different from the control group (P0.05). There was a significant difference between the parameters of the DTI parameters at various levels of the spinal cord tumor group (P0.05). There were differences between the FA value, the ADC value, FT value and FTR between the extramedullary and intramedullary tumor patients. Statistical significance (P0.05). There was a linear correlation between the FA value, ADC value, FT value and FTR of the lesion layer of the spinal cord tumor and the patient's clinical score except the ADC value and the AIS classification (P0.05), and there was a linear correlation between the values of the other parameters and the score values (P0.05).
Conclusion: DTI scan of spinal cord tumor can show morphological, structural and anisotropic changes in spinal cord. DTT images can show the displacement and damage of spinal cord fibers. The DTI scanning parameters of spinal tumors are abnormal, and the parameters of DTI parameters in the spinal cord of extramedullary and intramedullary tumors are also different. The parameters of the DTI scan of spinal tumors and the presence of the spinal cord tumor The score of the spinal cord is basically consistent with that of the.DTI score. It can better reflect the spinal cord injury and neurological function in patients with spinal cord tumors.
【学位授予单位】：第二军医大学
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R739.42;R445.2
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