两室模型与参照物模型在前列腺癌DCE-MRI中的对比研究

发布时间：2018-03-16 04:36

本文选题：动态增强磁共振成像　切入点：前列腺肿瘤　出处：《山东大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:应用 Extended Tofts 与 Reference Region model(RRM)两种药代动力学模型测量血管功能参数,比较两种模型在前列腺癌DCE-MRI诊断中的价值。并进行前列腺癌血管功能参数与前列腺特异性抗原密度(PSAD)间的相关性分析。资料和方法:对31例经TRUS或术后病理证实的前列腺癌患者(年龄50-81岁,平均62岁)行MRI常规序列及动态增强MRI扫描,应用Omni Kinetics Manual软件中的Extend Tofts和RRM模型测量前列腺癌区与非癌区的血管功能参数Ktrans(容量转移常数)、Ve(对比剂血管外细胞外液间隙容积比)、Kep(速率常数)及Vp(对比剂血浆容积比)。采用Kruskal-Wallis检验比较两模型中的血管功能参数,并对个血管功能参数的R0C曲线进行绘制,评估两模型所对应的各参数诊断前列腺癌的效能。应用Spearman秩相关对血管功能参数与PSAD间关系进行检验;P0.05为差异具有统计学意义。结果:1 Extend Tofts模型中癌区的Ktrans、Kep、Vp及Ve值分别为(0.338±0.157)min-1、(1.678±0.866)min-1 0.014±0.030、0.234±0.119,RRM 中 Ktrans、Kep及 Ve值分别为(3.233±1.650)min-1、(1.126±0.885)min、1.088±0.720。2.两模型中前列腺癌区与非癌区的血管功能参数Ktrans、Kep及Ve间均有统计学意义(P0.05),且癌区各参数平均值与非癌区相比均较高。3.Extend Tofts模型中Ktrans与Kep对前列腺癌诊断的敏感度及特异度均高于RRM(Ktrans为 91.8%、85.7%,89.8%、81%;Kep 为 93.9%、95.2%,67.3%、81%),Vp 对前列腺癌诊断的敏感度及特异度低于RRM(分别为38.8%、81.2%;75.5%、85.7%).4.在Extend Tofts 模型中Ktrans与Kep、Ve均呈正相关(r=0.438、0.511),Ktrans与Vp呈负相关(r=-0.561);在RRM中Ktrans与Kep、Vp间均呈正相关(r=0.624、0.451);两模型中Ktranss间呈正相关(r=0.327)。5.在Extend Tofts模型中,PSAD与Kep、Ve具有相关性(r=-0.414,0.420),与其它血管功能参数不具有相关性。结论:Extended Tofts模型更适于前列腺癌的诊断,其中血管功能参数Ktrans、Kep对前列腺癌的诊断效能最高,且PSAD与K_(ep)、V_e具有相关性。
[Abstract]:Objective: to measure vascular function parameters using two pharmacokinetic models: Extended Tofts and Reference Region model RRM. To compare the value of the two models in the diagnosis of prostate cancer with DCE-MRI, and to analyze the correlation between prostate cancer vascular function parameters and prostate specific antigen density (PSA). Data and methods: 31 cases were confirmed by TRUS or postoperative pathology. In patients with prostate cancer, aged 50-81, MRI routine sequence and dynamic enhanced MRI scan were performed. Using the Extend Tofts and RRM models in Omni Kinetics Manual software to measure the vascular function parameters of prostate cancer area and non-cancer area, KtransV (volume transfer constant) and Vp (contrast medium extracellular fluid volume ratio) and VP (contrast medium plasma volume). Kruskal-Wallis test was used to compare the vascular function parameters of the two models. And draw the R0C curve of each vascular function parameter, Spearman rank correlation was used to test the relationship between vascular function parameters and PSAD. Results Ktrans1 Extend Tofts model had significant difference in the diagnosis of prostate cancer. Results Ktrans1 Extend Tofts model had a significant difference in the relationship between vascular function parameters and PSAD. Results Ktrans1 Extend Tofts model showed that there was a significant difference in the relationship between vascular function parameters and PSAD. The values of Ktransmeg Kep and ve in the RRM of 0.338 卤0.157 min -1 and 1.678 卤0.866 min -1 0.014 卤0.030 卤0.234 卤0.19 min were 3.233 卤1.650 min -1, 1.126 卤0.885min 1.088 卤0.720.2.There was statistical significance between the two models in the blood vessel function parameters of the prostate cancer area and the non-cancer area, and the mean value of each parameter in the cancer area was higher than that in the non-cancerous area. 3.Extended Tofts model was higher than that in the non-cancer area. The sensitivity and specificity of Ktrans and Kep in the diagnosis of prostate cancer were higher than those in RRM(Ktrans. The sensitivity and specificity of Ktrans and Kep in the diagnosis of prostate cancer were higher than those in RRM(Ktrans. The sensitivity and specificity of Ktrans and Kep in the diagnosis of prostate cancer were higher than those in RRM(Ktrans. In the model of Extend Tofts, Ktrans and KepVe were both positively correlated with KepVe 0.8430.5111.The sensitivity and specificity of Kep for the diagnosis of prostate cancer were higher than that of RRM.The sensitivity and specificity of Ktrans and Kep for the diagnosis of prostate cancer were higher than those for RRM(Ktrans. In the model of Extend Tofts, Ktrans and KepVe were positively correlated with Ktrans and VP. There was a positive correlation between Ktrans and Kepan VP in RRM, and a positive correlation between Ktranss and Ktranss in Extend Tofts model. In the Extend Tofts model, there was no correlation between Ktranss and other vascular parameters. Conclusion: the Extend extended Tofts model is more suitable for the diagnosis of prostate cancer. The blood vessel function parameter KTransa Kep was the most effective in the diagnosis of prostate cancer, and PSAD was correlated with KT / V _ e.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R737.25

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