体素内不相干运动与动脉自旋标记技术在胶质瘤术前分级中的应用

发布时间：2018-04-11 20:38

本文选题：磁共振成像 + 动脉自旋标记　；参考：《安徽医科大学》2017年硕士论文

【摘要】：目的:探讨体素内不相干运动与动脉自旋标记技术对胶质瘤术前分级的价值。方法:选取经手术病理证实为胶质瘤患者31例,所有患者检查前均未行任何治疗,其中女性患者13例,男性患者18例,年龄26~74岁,平均年龄为52.6岁,低级别胶质瘤12例,高级别胶质瘤19例。所有患者术前均行常规磁共振、3D-ASL及IVIM扫描,将所得原始数据经软件处理获得CBF图、D*图及D图,选取感兴趣区,计算相应的参数值。所有参数值采用SPSS软件进行分析,用两独立样本t检验比较高、低级别胶质瘤组间的各个参数值,P0.05为具有统计学意义。利用ROC曲线获得各个参数的最佳阈值、敏感性及特异性,并联合筛检3D-ASL与IVIM两种成像方法的最佳指标,获得敏感性及特异性。结果:1.高级别胶质瘤组的肿瘤CBF值、r CBF值(103.89±27.00ml/min·100g、4.28±0.63)分别高于低级别胶质瘤组的CBF值、r CBF值(63.96±22.17ml/min·100g、2.72±0.84),差异有统计学意义(P0.05);高级别胶质瘤组的肿瘤D*值、r D*值(3.82±0.60mm~2/s、1.95±0.30)分别高于低级别胶质瘤组的D*值、r D*值(2.54±0.50mm~2/s、1.28±0.14),D值、r D值(0.58±0.12mm~2/s、2.40±0.49)分别低于低级别胶质瘤组的D值、r D值(0.75±0.12mm~2/s、3.11±0.42),差异均有统计学意义(P0.05);2.利用ROC曲线分析,肿瘤CBF值的曲线下面积为0.879,最佳阈值为79.24ml/min·100g,敏感性、特异性为84.2%、83.3%;r CBF值的曲线下面积为0.917,最佳阈值为2.85,其敏感性、特异性为100%、83.3%;肿瘤D*、D、r D*和r D值的曲线下面积分别为0.925、0.846、0.956和0.882,最佳阈值分别为2.95mm~2/s、0.63mm~2/s、1.40、2.95,敏感性、特异性为94.7%、83.3%和91.7%、73.3%和94.7%、91.7%和75%、94.7%;3.3D-ASL联合IVIM成像对胶质瘤进行术前分级的敏感性及特异性分别为100%、91.7%。结论:1.CBF、D*、D值及r CBF、r D*、r D值在高、低级别胶质瘤之间差异存在统计学意义,可用于术前对胶质瘤进行分级,且r CBF、r D*、r D值优于CBF、D*、D值;2.单个功能成像技术可用于胶质瘤进行术前分级,但其敏感性及特异性欠佳,3D-ASL联合IVIM成像可提高胶质瘤术前分级的敏感性及特异性。
[Abstract]:Objective: to investigate the value of voxel incoherent motion and arterial spin labeling in preoperative grading of gliomas.Methods: 31 cases of glioma proved by operation and pathology were selected. All the patients were not treated before examination. Among them, 13 cases were female, 18 cases were male, the average age was 52.6 years old, 12 cases were low grade glioma.19 cases of high grade glioma.All the patients underwent conventional MRI 3D-ASL and IVIM scanning before operation. The original data were processed by software to obtain the CBF map D * and D map. The region of interest was selected and the corresponding parameter values were calculated.All the parameter values were analyzed by SPSS software. The t test of two independent samples was relatively high, and the value of each parameter between the low grade glioma group was statistically significant (P0.05).The optimum threshold value, sensitivity and specificity of each parameter were obtained by using ROC curve, and the best indexes of 3D-ASL and IVIM imaging methods were screened together to obtain the sensitivity and specificity.The result is 1: 1.By ROC curve analysis, the area under the curve of tumor CBF value was 0.879, the optimum threshold was 79.24ml/min 100g, the sensitivity, the area under the curve with specificity of 84.2and 83.3r CBF was 0.917, and the optimum threshold was 2.85.Conclusion: 1. There is statistical difference between the D value of CBFN D and the value of r CBFN D in high and low grade gliomas, which can be used to grade gliomas before operation, and the value of r CBFN r D is better than that of CBFN D and D value.Single functional imaging technique can be used to grade gliomas before operation, but the sensitivity and specificity of 3D-ASL combined with IVIM imaging can improve the sensitivity and specificity of preoperative grading of gliomas.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R739.41

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