IVIM与DCE-MRI对RRMS病灶及NAWM区的研究
发布时间：2018-12-14 10:40
【摘要】：目的多发性硬化(Multiple sclerosis,MS)是最常见的一种中枢神经系统慢性炎性脱髓鞘疾病,具有病灶多发、病程反复发作的特征,是造成青少年致残的最主要原因。磁共振体素内不相干运动(Intravoxel incoherent motion,IVIM)扩散成像是近年来快速发展的一种能无创、定量评估人体内体素规模运动的成像方法,可准确反映组织微环境的扩散及灌注特点,目前此方法已得到广泛应用。动态增强磁共振成像(Dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)是近年来发展迅速并得到广泛应用的一种定量灌注成像方法,而目前用此方法对MS扩散及灌注特点的研究较少。本研究旨在探讨运用IVIM和DCE-MRI定量分析MS患者病灶及看似正常白质(normal-appearing white matter,NAWM)区微血管渗透性、灌注及分子扩散状态的可行性,以期进一步研究MS微循环的病理生理及血流动力学改变。材料与方法27例复发-缓解型多发性硬化(RRMS)患者行常规MRI和IVIM扫描,取多个b值(10,20,30,40,50,100,150,200,350,500,650,800,1000 s/mm2),获取反映RRMS患者病灶及NAWM区组织扩散特点的表观扩散系数(apparent diffusion coefficient,ADC)、ADCslow、ADCfast及组织微血管灌注f值。23例RRMS患者行常规MRI和DCE-MRI检查并应用单室Patlak模型后处理,定量分析MS患者病灶及NAWM区反映微血管渗透性的标记物即容积转移常数Ktrans、血浆内对比剂百分比Vp及灌注参数:脑血流量(CBF)和脑血容量(CBV)值。结果1)非强化病灶区的ADC、ADCslow、ADCfast明显高于病灶旁及远离病灶的NAWM区(H1=46.16,H2=27.32,H3=8.93,P0.05)。而非强化病灶区的f值明显低于病灶旁及远离病灶的NAWM区(H=17.99,P0.05)。病灶旁NAWM区与远离病灶的NAWM区均无统计学意义(P0.05)。2)非强化病灶、病灶旁NAWM区及远离病灶的NAWM区之间两两比较,MS患者非强化病灶的Ktrans明显高于远离病灶的NAWM区(χ2=7.58,P0.05)。其余两组间的Ktrans值差异无统计学意义(P0.05)。3)非强化病灶CBV明显高于远离病灶的NAWM区,差异有统计学意义(χ2=6.39,P0.05)。非强化病灶的CBV略高于病灶旁NAWM区,但均无统计学意义(P0.05)。4)非强化病灶、病灶旁NAWM区及远离病灶的NAWM区三组之间的Vp、CBF值差异均无统计学意义(P0.05)。结论磁共振IVIM成像能定量分析RRMS患者病灶与NAWM区组织的扩散及灌注特点,有助于推测病灶的病理改变,对损伤分类及鉴别提供帮助。DCE-MRI采用Patlak模型能定量分析MS患者病灶及NAWM区的微血管渗透及灌注特点,准确地反应MS的血流动力学改变。
[Abstract]:Objective multiple sclerosis (Multiple sclerosis,MS) is the most common chronic inflammatory demyelinating disease of central nervous system. (Intravoxel incoherent motion,IVIM diffusion imaging is a kind of noninvasive imaging method which can be developed rapidly in recent years. It can accurately reflect the diffusion and perfusion characteristics of tissue microenvironment by quantitatively evaluating the size motion of human voxel. At present, this method has been widely used. Dynamic enhanced magnetic resonance imaging (Dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI) is a rapidly developed and widely used quantitative perfusion imaging method in recent years, but it is seldom used to study the diffusion and perfusion characteristics of MS. The purpose of this study was to investigate the feasibility of quantitative analysis of microvascular permeability, perfusion and molecular diffusion in patients with MS and in the seemingly normal white matter (normal-appearing white matter,NAWM) area by IVIM and DCE-MRI. To further study the pathophysiological and hemodynamic changes of MS microcirculation. Materials and methods 27 patients with relapsed and remitting multiple sclerosis (RRMS) underwent routine MRI and IVIM scans, and multiple b values (10 ~ 20 ~ 30 ~ 4050 ~ 50 ~ 100 ~ 150 ~ 150 ~ 100 ~ 200 ~ 350 ~ 500 ~ 650 ~ 800 ~ 1000 s/mm2) were taken to obtain the apparent diffusion coefficient (apparent diffusion coefficient,ADC), which could reflect the characteristics of the lesions and the tissue diffusion in the NAWM area of RRMS patients. ADCslow,ADCfast and tissue microvascular perfusion f value. 23 patients with RRMS were examined by routine MRI and DCE-MRI and treated with single compartment Patlak model. Quantitative analysis of the lesion and NAWM marker reflecting microvascular permeability in MS patients, I. e., volume transfer constant Ktrans, Vp and perfusion parameters: cerebral blood flow (CBF) and cerebral blood volume (CBV). Results 1) the ADC,ADCslow,ADCfast in the unenhanced lesion area was significantly higher than that in the NAWM region near the lesion and far away from the lesion (H1 46.16H _ 2H _ (27.32) H _ (3) P _ (8.93) P _ (0.05). The f value of the unenhanced focus area was significantly lower than that of the NAWM region (P 0.05). There was no significant difference between the adjacent NAWM area and the NAWM region away from the lesion (P0.05). There was no significant difference between the adjacent NAWM area and the NAWM region away from the lesion. The Ktrans of unenhanced lesions in MS patients was significantly higher than that in NAWM areas far away from the lesions (蠂 2 7.58 P 0.05). There was no significant difference in Ktrans between the other two groups (P0.05). 3) the CBV of unenhanced focus was significantly higher than that of far away NAWM (蠂 2 + 6.39% P 0.05). The CBV of the unenhanced lesions was slightly higher than that of the adjacent NAWM areas, but there was no statistical significance (P0.05). There was no significant difference in Vp,CBF values between the three groups in the NAWM region adjacent to the lesion and the NAWM area away from the lesion (P0.05). Conclusion IVIM imaging can quantitatively analyze the characteristics of diffusion and perfusion between the lesions and the NAWM area in RRMS patients, and is helpful to speculate the pathological changes of the lesions. DCE-MRI with Patlak model can quantitatively analyze the characteristics of microvascular permeability and perfusion in the lesion and NAWM area of MS patients, and accurately reflect the hemodynamic changes of MS.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R744.51
本文编号：2378471
[Abstract]:Objective multiple sclerosis (Multiple sclerosis,MS) is the most common chronic inflammatory demyelinating disease of central nervous system. (Intravoxel incoherent motion,IVIM diffusion imaging is a kind of noninvasive imaging method which can be developed rapidly in recent years. It can accurately reflect the diffusion and perfusion characteristics of tissue microenvironment by quantitatively evaluating the size motion of human voxel. At present, this method has been widely used. Dynamic enhanced magnetic resonance imaging (Dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI) is a rapidly developed and widely used quantitative perfusion imaging method in recent years, but it is seldom used to study the diffusion and perfusion characteristics of MS. The purpose of this study was to investigate the feasibility of quantitative analysis of microvascular permeability, perfusion and molecular diffusion in patients with MS and in the seemingly normal white matter (normal-appearing white matter,NAWM) area by IVIM and DCE-MRI. To further study the pathophysiological and hemodynamic changes of MS microcirculation. Materials and methods 27 patients with relapsed and remitting multiple sclerosis (RRMS) underwent routine MRI and IVIM scans, and multiple b values (10 ~ 20 ~ 30 ~ 4050 ~ 50 ~ 100 ~ 150 ~ 150 ~ 100 ~ 200 ~ 350 ~ 500 ~ 650 ~ 800 ~ 1000 s/mm2) were taken to obtain the apparent diffusion coefficient (apparent diffusion coefficient,ADC), which could reflect the characteristics of the lesions and the tissue diffusion in the NAWM area of RRMS patients. ADCslow,ADCfast and tissue microvascular perfusion f value. 23 patients with RRMS were examined by routine MRI and DCE-MRI and treated with single compartment Patlak model. Quantitative analysis of the lesion and NAWM marker reflecting microvascular permeability in MS patients, I. e., volume transfer constant Ktrans, Vp and perfusion parameters: cerebral blood flow (CBF) and cerebral blood volume (CBV). Results 1) the ADC,ADCslow,ADCfast in the unenhanced lesion area was significantly higher than that in the NAWM region near the lesion and far away from the lesion (H1 46.16H _ 2H _ (27.32) H _ (3) P _ (8.93) P _ (0.05). The f value of the unenhanced focus area was significantly lower than that of the NAWM region (P 0.05). There was no significant difference between the adjacent NAWM area and the NAWM region away from the lesion (P0.05). There was no significant difference between the adjacent NAWM area and the NAWM region away from the lesion. The Ktrans of unenhanced lesions in MS patients was significantly higher than that in NAWM areas far away from the lesions (蠂 2 7.58 P 0.05). There was no significant difference in Ktrans between the other two groups (P0.05). 3) the CBV of unenhanced focus was significantly higher than that of far away NAWM (蠂 2 + 6.39% P 0.05). The CBV of the unenhanced lesions was slightly higher than that of the adjacent NAWM areas, but there was no statistical significance (P0.05). There was no significant difference in Vp,CBF values between the three groups in the NAWM region adjacent to the lesion and the NAWM area away from the lesion (P0.05). Conclusion IVIM imaging can quantitatively analyze the characteristics of diffusion and perfusion between the lesions and the NAWM area in RRMS patients, and is helpful to speculate the pathological changes of the lesions. DCE-MRI with Patlak model can quantitatively analyze the characteristics of microvascular permeability and perfusion in the lesion and NAWM area of MS patients, and accurately reflect the hemodynamic changes of MS.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R744.51
【参考文献】
相关期刊论文 前4条
1 尹平;刘义;周津如;时晓清;曾春;王静杰;李咏梅;;动态对比增强MRI Tofts模型在复发-缓解型多发性硬化中的应用[J];中国医学影像学杂志;2015年12期
2 宋琼;马静;饶圣祥;姚秀忠;陈财忠;曾蒙苏;;MR全肝增强灌注Tofts模型分析对肝癌微循环功能状态的影像生物学标记物的评价研究[J];放射学实践;2013年06期
3 尹茵;甘洁;;体素内不相干运动成像[J];中国临床医学影像杂志;2013年05期
4 曾春;李咏梅;罗天友;吕发金;欧阳羽;陈璇;王忠平;谢鹏;;动态磁敏感对比MR灌注成像对多发性硬化的研究[J];临床放射学杂志;2010年08期
，本文编号：2378471
本文链接：https://www.wllwen.com/yixuelunwen/fangshe/2378471.html
