DCE-MRI在脑胶质瘤分级中的应用研究

发布时间：2018-03-24 20:00

本文选题：动态对比增强磁共振　切入点：高级别胶质瘤　出处：《青岛大学》2017年硕士论文

【摘要】：目的:探讨动态对比增强磁共振成像(dynamic contrast-enhanced MRI,DCE-MRI)在脑胶质瘤分级中的应用,并对血流动力学双室模型Extended Tofts Linear的复测性(reproducibility)进行研究。材料与方法:收集我院2014年11月至2017年2月术前行DCE-MRI和增强MRI检查、术后经病理证实的脑胶质瘤35例,其中高级别胶质瘤23例(男:女=12:11;平均年龄47岁),低级别胶质瘤12例(男:女=4:8;平均年龄52岁)。通过血流动力学双室模型对各组数据定量分析,获取肿瘤实性成分及瘤周区(1cm内水肿区或邻近脑实质)的血流动力学参数:转运系数-Ktrans、血管外细胞外间隙对比剂的容积分数-Ve、血管内对比剂的容积分数-Vp、血液从血管外细胞外间隙(EES)渗回血管的速率-Kep。通过统计软件分析,对比各参数在高、低级别胶质瘤实性成分及瘤周区是否存在统计学差异。并通过两名高年资的放射科医生单独、分批次应用Extend Tofts Linear模型对DCE-MRI图像进行血管渗透性定量分析,分别比较两组各参数在高、低级别胶质瘤瘤体中是否存在统计学差异,由此分析后处理模型的复测性。结果:高、低级别胶质瘤肿瘤实性成分的Ktrans值、Ve值、Vp值、Kep值差异有统计学意义(P0.05)。高、低级别胶质瘤瘤周区Ktrans值、Ve值、Vp值、Kep值差异无统计学意义(P0.05)。测量1、测量2两组高、低级别胶质瘤瘤体的Ktrans值、Ve值及Vp值差异均有统计学意义(P0.05)。测量1、测量2两组Ktrans值、Ve值及Vp值可重复性比较的组内相关系数(ICC)值分别为0.93、0.809、0.592,均大于0.4。结论:通过定量分析瘤体及瘤周区的Ktrans值、Ve值、Vp值、Kep值,可为高、低级别胶质瘤的鉴别诊断提供定量依据。且血流动力学双室模型Extended Tofts Linear在脑胶质瘤DCE-MRI血管渗透性定量分析具有很好的复测性。
[Abstract]:Objective: to investigate the application of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in the classification of gliomas. Materials and methods: from November 2014 to February 2017, 35 cases of glioma were examined by DCE-MRI and enhanced MRI. 23 cases of high grade gliomas (male: female 12: 11; mean age 47 years old) and 12 cases of low grade gliomas (male: female 4: 8; mean age 52 years old). The hemodynamic parameters of the solid components of the tumor and the edema area in the surrounding area of 1 cm or adjacent brain parenchyma) were obtained: transport coefficient -Ktrans, volume fraction of extracellular extracellular contrast agent -Vee, volume fraction of intravascular contrast agent -Vp, blood from. The rate of extravascular osmotic osmosis of EES was analyzed by statistical software. The parameters were compared in high and low grade gliomas and whether there were statistical differences in the solid components and surrounding areas. Two radiologists with high seniority were used to analyze the vascular permeability of DCE-MRI images in batches using Extend Tofts Linear model. The parameters of the two groups in the high and low grade glioma tumor were compared whether there were statistical differences, so as to analyze the repeatability of the post-processing model. There were significant differences in Ktrans value and V _ p value of solid components of low grade gliomas (P < 0.05). There was no significant difference in Ktrans value and V _ p value and V _ p value between low grade gliomas and low grade gliomas (P < 0.01). There were significant differences in Ktrans value and VP value in low grade gliomas (P < 0. 05). The correlation coefficient was 0. 93 / 0. 809 / 0. 592in the two groups, respectively. Conclusion: the Ktrans value and V p value repeatability of the two groups were more than 0. 42.Conclusion: by determining the value of Vp, the correlation coefficient is more than 0. 41.Conclusion: both of the two groups are more than 0. 592% (P < 0. 05). The Ktrans value and V _ p value and V _ p value of the tumor and its surrounding area were analyzed quantitatively. It can provide quantitative basis for differential diagnosis of high and low grade gliomas, and Extended Tofts Linear, a two-compartmental hemodynamic model, has good reproducibility in quantitative analysis of DCE-MRI vascular permeability in gliomas.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R739.41

【参考文献】