鼻咽癌动态增强MRI与扩散加权成像研究

发布时间：2018-05-03 12:35

本文选题：鼻咽癌 + 动态增强磁共振成像　；参考：《暨南大学》2012年硕士论文

【摘要】：目的：研究分析鼻咽癌（nasopharyngeal carcinoma，NPC）动态增强MRI（dynamiccontrast-enhanced MRI，DCE-MRI）与扩散加权成像（diffusion-weighted MRI，DWI）表现，加深对其认识水平。方法： 1、一般资料：收集我院2010年12月至2012年3月期间收治的经病理证实NPC初诊患者30例，均行常规MRI平扫+SE EPI DWI+DCE MRI+常规增强扫描。 2、图像后处理：使用GE ADW4.2后处理工作站的Functool软件对DCE MRI图像和DWI图像进行数据后处理。绘制NPC病灶感兴趣区，获取DCE-MRI的T-SI曲线（Time-Signal Intensity curve，T-SI curve），分别测量并记录感兴趣区的ADC值和动态增强特征性参数值，包括正性增强积分（positive enhancement integral，PEI）、至峰值时间（time to peak，TP）及最大上升斜率（maximum slope of increase，MSI）,手动计算得出相对PEI值、相对TP值及相对MSI值，并进行统计学分析。 3、统计方法：采用SPSS19.0统计软件。统计量采用均数±标准差（x±s）的形式表示，对计数资料行χ2检验，对计量资料行两独立样本t检验，P＜0.05为差异具有统计学意义。结果： 1、NPC鼻咽病灶T-SI曲线表现为速升-平台型（18例）、速升-缓降型（7例）和缓升-平台型（5例）。 2、NPC鼻咽病灶与同侧肌肉PEI值、TP值与MSI值的均数不同，，差异有统计学意义（P＜0.05）。 3、NPC I型、II型、III型的PEI值与相对PEI值的均数呈递增趋势，PEI值II型与III型之间、I型与III型之间差异有统计学意义（P＜0.05）；相对PEI值II型与III型之间差异有统计学意义（P＜0.05）。 4、NPC I型、II型、III型的相对TP值均数呈递减趋势，但经统计学处理，差异均无统计学意义（P＞0.05）；II型与III型之间的TP值差异有统计学意义（P＜0.05）。 5、NPC I型、II型、III型的MSI值与相对MSI值的均数呈递增趋势，但其差异均无统计学意义。 6、NPC I型、II型、III型的ADC值的均数呈递减趋势，但其差异均无统计学意义。 7、NPC鼻咽病灶T-SI曲线类型A型与C型在有无淋巴结转移方面，差异有统计学意义（P＜0.05）。结论：不同影像表现类型的NPC在DCE-MRI及DWI扫描上有所不同，MR功能成像能初步反映肿瘤微循环及水分子运动状态的生物学信息。
[Abstract]:Objective: To study and analyze the dynamic enhanced MRI(dynamiccontrast-enhanced DCE-MRI (nasopharyngeal carcinoma) and diffusion-weighted DWI (DWI) in nasopharyngeal carcinoma (NPC), and to deepen the understanding of the DCE-MRI. Methods: 1. General data: 30 patients with pathologically proved NPC were collected from December 2010 to March 2012, all of whom underwent conventional MRI plain EPI EPI DWI DCE MRI conventional enhanced scanning. 2, image post-processing: DCE MRI image and DWI image are processed by Functool software of GE ADW4.2 post-processing workstation. The region of interest in NPC was drawn, and the T-SI curve of DCE-MRI was obtained. The ADC values of the region of interest and the characteristic parameters of dynamic enhancement were measured and recorded. It includes positive enhancement integral slope, time to peak value and maximum slope of increasing slope. The relative PEI value, relative TP value and relative MSI value are calculated manually and analyzed statistically. 3. Statistical method: SPSS19.0 software was used. The statistics were expressed in the form of mean 卤standard deviation (x 卤s). The difference was statistically significant between the two independent samples (P < 0.05) and the counting data (蠂 2 test). Results: 1the T-SI curve of nasopharynx lesions showed rapid ascending to platform type in 18 cases, rapid ascending to slow descending type in 7 cases and slow ascending to platform type in 5 cases. 2the mean values of PEI and MSI in nasopharyngeal lesions and ipsilateral muscles were different (P < 0.05). 3There was an increasing trend between the PEI value and the relative PEI value of the PEI value and the relative PEI value. There was significant difference between III type II type and III type (P < 0.05), and there was significant difference between PEI type II type and III type (P < 0.05). (4) the relative TP value of NPCs type I type II and III type II showed a decreasing trend, but the difference was not statistically significant (P > 0.05) between the two types (P < 0.05), but there was no significant difference between the two types (P > 0.05), and there was no significant difference in TP between the two types (P < 0.05), but there was no significant difference between the two types (P > 0.05). (5) the mean of MSI and relative MSI showed an increasing trend, but there was no significant difference between them. The mean of ADC in type I and II of NPCs showed a decreasing trend, but there was no significant difference between them. There was significant difference in T-SI curve type A and C between NPC and NPC with or without lymph node metastasis (P < 0.05). Conclusion: NPC with different imaging types could reflect the biological information of tumor microcirculation and water molecule motion on DCE-MRI and DWI.
【学位授予单位】：暨南大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R445.2;R739.63

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