IVIM和DKI在胰腺癌与慢性肿块型胰腺炎鉴别诊断价值研究

发布时间：2018-07-05 06:41

本文选题：IVIM + f灌注分数　；参考：《吉林大学》2014年硕士论文

【摘要】：目的：初步评价IVIM和DKI的参数在胰腺癌与慢性肿块型胰腺炎鉴别诊断的临床应用价值。材料与方法：2013年7月至2014年3月共有14名经病理证实的胰腺癌患者（男9名，女5名，年龄52～73岁，中位年龄62岁）、9名经病理（n=3）及临床随访（n=6）证实的慢性胰腺炎患者（男4名，女5名，年39～69岁，中位年龄51岁）纳入本研究。受试者在3.0T飞利浦磁共振扫描仪上分别接受11个b值的呼吸触发IVIM序列扫描，（b值设定为0,25,50,75,100,150，200,300,400,600,800s/mm2），，以及5个b值的呼吸触发DKI序列扫描，(b值设定为0，500,1000,1500,2000s/mm2）。应用IVIM模型计算D、f及D*，应用DKI模型计算MD及MK，选取b值0及600拟合计算表观弥散系数ADC值。通过方差分析及q检验比较各参数在胰腺癌、慢性胰腺炎及正常胰腺间的差异；采用ROC曲线分析比较IVIM及DKI在诊断及鉴别诊断的价值。结果：f在胰腺癌、慢性胰腺炎及正常胰腺间均存在显著统计学差异（8.36±2.34vs13.77±3.22vs25.1±5.8%，P0.01）；D*在胰腺癌和胰腺炎低于正常胰腺（29±8.8/35±6.2vs57.1±7.8×10-3mm2/s，P＜0.05），但在胰腺癌及胰腺炎间无统计学差异（P=0.100）；D在慢性胰腺炎中低于胰腺癌和正常胰腺（0.98±0.15vs1.26±0.19/1.32±0.17×10-3mm2/s，P＜0.05），但在胰腺癌和正常胰腺间无统计学差异（P=0.413）；Mk在胰腺癌、慢性胰腺炎及正常胰腺间均存在显著统计学差异（0.90±0.056vs0.82±0.034vs0.66±0.15，p0.01）,MD在正常胰腺中明显高于胰腺癌及慢性胰腺炎（2.30±0.20vs2.06±0.12/2.02±0.13×10-3mm2/s，P＜0.05），但在胰腺癌及慢性胰腺炎间无统计学差异（P=0.418）；ADC值在正常胰腺显著高于胰腺癌和慢性胰腺炎（1.38±0.24vs1.09±0.19/1.11±0.16×10-3mm2/s，P＜0.01），但在胰腺癌和慢性胰腺炎间无统计学差异（P=0.883）。IVIM的参数f及DKI的参数MK的ROC曲线下面积分别为0.92和0.86，两者间无统计学差异（P=0.532）。结论：与正常胰腺组织和慢性肿块型胰腺炎相比，胰腺癌病变区域f值明显降低、MK值明显增高。IVIM模型和DKI模型对胰腺癌和慢性肿块型胰腺炎的诊断和鉴别诊断具有临床应用价值。
[Abstract]:Objective: to evaluate the clinical value of IVIM and DKI in the differential diagnosis of pancreatic cancer and chronic mass pancreatitis. Materials and methods: from July 2013 to March 2014, there were 14 pathologically confirmed pancreatic cancer patients (9 males and 5 females, aged 52 to 73 years). Nine patients with chronic pancreatitis (male 4, female 5, aged 3969 years, median age 51 years) confirmed by pathology and clinical follow-up were included in this study. The subjects received 11 b respiratory trigger IVIM sequences on 3.0T Philips magnetic resonance scanner. The, (b values were set to 0 2550V 75100150 200300400600800smm2, and the, (b values of 5 b values for respiratory triggered DKI sequences were set to 0 / 500,000,000,000,000sr / mm2). The DIFs and DKs were calculated by IVIM model, MD and MKs were calculated by DKI model, and the apparent diffusion coefficient ADC values were calculated by fitting b values 0 and 600. Variance analysis and Q test were used to compare the difference of parameters between pancreatic cancer, chronic pancreatitis and normal pancreas, and the value of IVIM and DKI in diagnosis and differential diagnosis were compared by ROC curve analysis. Results there was a significant difference (8.36 卤2.34vs13.77 卤3.22vs25.1 卤5.8mm ~ (0.01) between pancreatic cancer, chronic pancreatitis and normal pancreas (P < 0. 05), but there was no significant difference (P < 0. 05) between pancreatic cancer and pancreatitis (29 卤8. 8 卤35 卤6.2vs57.1 卤7. 8 脳 10 ~ (-3) mm ~ (2) P < 0. 05). D was lower in chronic pancreatitis than that in normal pancreas (0.98 卤0.15vs1.26 卤0.19 卤1.32 卤0.17 脳 10 ~ (-3) mm ~ (-2) P < 0. 05), but there was no significant difference between pancreatic cancer and normal pancreas (P < 0. 413). There was significant difference between chronic pancreatitis and normal pancreas (0.90 卤0.056vs0.82 卤0.034vs0.66 卤0.15p0.01). The MD in normal pancreas was significantly higher than that in normal pancreas and chronic pancreatitis (2.30 卤0.20vs2.06 卤0.12 卤2.02 卤0.13 脳 10 ~ (-3) mm ~ (-2) P < 0. 05), but there was no significant difference between pancreatic cancer and chronic pancreatitis (P _ 0.418). The ADC values in normal pancreas were significantly higher than those in normal pancreas and chronic pancreatitis (1.38 卤0.24vs1.09 卤0.19 卤1.11 卤0.16 脳 10 ~ (-3) mm ~ (-2) P < 0. 01), but there was no significant difference between pancreatic cancer and chronic pancreatitis (P < 0. 01). The area under the ROC curve of parameters f of IVIM and MK of DKI was 0. 92 and 0. 86, respectively (P0. 532). Conclusion: compared with normal pancreatic tissue and chronic mass pancreatitis, The value of f in the lesion area of pancreatic cancer was significantly decreased. The IVIM model and DKI model were of clinical value in the diagnosis and differential diagnosis of pancreatic cancer and chronic mass pancreatitis.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R735.9;R576

【参考文献】