磁共振扩散张量成像在颅内肿瘤鉴别诊断中的应用

发布时间：2018-07-10 13:35

本文选题：磁共振成像 + 星形细胞肿瘤　；参考：《滨州医学院》2014年硕士论文

【摘要】：第一部分扩散张量成像在不典型脑膜瘤与星形细胞肿瘤鉴别中的应用目的：通过测量不典型脑膜瘤和星形细胞肿瘤实质区、瘤周区以及正常脑白质区的FA值和ADC值,来评价扩散张量成像(DTI)的临床应用价值。方法收集17例不典型脑膜瘤和28例星形细胞肿瘤患者,行DTI序列检查。分别测量两组不同肿瘤各个不同感兴趣区的FA值和ADC值。用统计学软件SPSS19.0分别对两组不同肿瘤各个不同感兴趣区的FA值和ADC值进行统计学分析,P0.05为差异有统计学意义。结果不典型脑膜瘤肿瘤实质区、瘤周区、健侧正常脑白质区FA值分别为0.23±0.05、0.20±0.04、0.28±0.04；星形细胞肿瘤上述3个区FA值分别为0.05±0.01、0.14±0.03、0.26±0.04,上述两组不同肿瘤实质区、瘤周区FA值比较均有显著统计学差异,不典型脑膜瘤肿瘤实质区和瘤周区FA值高于星形细胞肿瘤(P0.05)。不典型脑膜瘤肿瘤实质区、瘤周区、健侧正常脑白质区ADC值(×10-9mm2/s)分别为0.82±0.13、1.22±0.32、0.73±0.10；星形细胞肿瘤上述3个区ADC值(×10-9mm2/s)分别为1.58±0.17、1.41±0.10、0.70±0.06。上述两组不同肿瘤实质区、瘤周区ADC值比较均有显著统计学差异。结论测量肿瘤实质区和瘤周区FA值和ADC值,在临床上可以帮助我们鉴别不典型脑膜瘤和星形细胞肿瘤。DTT对不典型脑膜瘤和星形细胞肿瘤术前评价有较高的实践价值。第二部分扩散张量成像在不同病理类型的星形细胞肿瘤鉴别中的应用目的：探讨扩散张量成像(DTI)在鉴别不同病理类型的星形细胞肿瘤中的价值。资料与方法：收集67例不同病理类型星形细胞肿瘤患者,所有病例均行T1WI、T2WI、FLAIR、TlWIGd-DTPA增强扫描和DTI检查,均经病理证实。分别测量肿瘤瘤实质区与正常脑白质区的ADC值,分析比较不同病理类型星形细胞肿瘤实质区和健侧正常脑白质区ADC值,用统计学软件SPSS19.0分别对不同病理类型的星形细胞肿瘤实质区的ADC值进行统计学分析,P0.05为差异有统计学意义。结果纤维型星形细胞瘤、肥胖细胞型星形细胞瘤、间变性星形细胞瘤及巨细胞型胶质母细胞瘤实质区、健侧正常脑白质区ADC值(×10-9mm2/s)分别为(1.48±0.12、0.72±0.05)、(1.31±0.07、0.69±0.03)、(1.06±0.11、0.71±0.04)、(0.98±0.09、0.73±0.04)。纤维型星形细胞瘤与肥胖细胞型星形细胞瘤肿瘤实质区ADC值比较有统计学差异(P0.001)；纤维型星形细胞瘤和肥胖细胞型星形细胞瘤与间变性星形细胞瘤肿瘤和巨细胞型胶质母细胞瘤肿瘤实质区ADC值比较均有显著统计学差异(P0.001)；间变性星形细胞瘤与巨细胞型胶质母细胞瘤肿瘤实质区ADC值比较无统计学差异(P=0.070.05)。结论测量肿瘤实质区ADC值可鉴别不同病理类型的星形细胞肿瘤,但是不能够轻易鉴别间变性星形细胞瘤和巨细胞型胶质母细胞瘤；DTI对星形细胞肿瘤术前评价有较高的实践价值。
[Abstract]:Part I Application of Diffusion Zhang Liang Imaging in differentiating atypical meningioma from astrocytoma objective: to measure the FA and ADCs of atypical meningioma and astrocytoma parenchyma, peri-tumor and normal white matter area. To evaluate the clinical value of diffusion Zhang Liang imaging. Methods 17 cases of atypical meningioma and 28 cases of astrocytoma were examined by DTI sequence. FA and ADC values of different regions of interest were measured. Statistical software SPSS 19.0 was used to analyze the FA value and ADC value of different regions of interest in two groups respectively. Results the FA values of atypical meningioma tumor parenchyma, peri-tumor area and normal white matter area were 0.23 卤0.05U 0.20 卤0.04U 0.28 卤0.04, respectively, and those of astrocytoma were 0.05 卤0.010.14 卤0.03n 0.26 卤0.04, respectively. FA values of atypical meningioma were significantly higher than that of astrocytoma (P0.05). The ADC values (脳 10-9mm2/s) of atypical meningiomas were 0.82 卤0.131.22 卤0.32 卤0.32 卤0.10 and 1.58 卤0.171.41 卤0.100.70 卤0.06, respectively. The ADC values of different tumor parenchyma and surrounding area were significantly different between the two groups. Conclusion measuring FA value and ADC value in parenchymal and peri-tumor areas can help us to differentiate atypical meningioma from astrocytoma. DTT has high practical value in preoperative evaluation of atypical meningioma and astrocytoma. Part two Application of Diffusion Zhang Liang Imaging in differential diagnosis of astrocytic tumors of different pathological types objective: to explore the value of diffusive Zhang Liang imaging in differentiating astrocytic tumors with different pathological types. Materials and methods: 67 cases of astrocytoma with different pathological types were collected. All cases were examined with T1WII T2WIFLAIRPA-TlWIGd-DTPA enhanced scan and DTI, all of which were confirmed by pathology. The ADC values in the parenchyma of tumor and the white matter of the normal brain were measured, and the ADC values of the parenchyma of astrocytoma and the normal white matter of the contralateral side were analyzed and compared in different pathological types of astrocytoma. Statistical software SPSS 19.0 was used to analyze the ADC values of astrocytoma parenchyma in different pathological types. Results the ADC values of fibrous astrocytoma, obese astrocytoma, anaplastic astrocytoma and giant cell glioblastoma were (1.48 卤0.120.72 卤0.05), (卤0.07 卤0.07), (1.06 卤0.110.71 卤0.04), (0.98 卤0.090.73 卤0.04) respectively. The ADC values in the parenchymal region of fibrous astrocytoma and obese astrocytoma were significantly different (P0.001). The ADC values in the parenchymal region of fibroid astrocytoma and obese astrocytoma were significantly different from those of anaplastic astrocytoma tumor and giant cell glioblastoma tumor (P0.001). There was no significant difference in ADC between anaplastic astrocytoma and giant glioblastoma (P0.070.05). Conclusion measuring ADC values of tumor parenchyma can differentiate astrocytoma from anaplastic astrocytoma and giant cell glioblastoma. DTI has high practical value in preoperative evaluation of astrocytoma.
【学位授予单位】：滨州医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2;R739.41

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