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1、毕业论文MRI灌注和扩散加权成像对脑胶质瘤分级的比较研究2014年6月25日MRI灌注和扩散加权成像对脑胶质瘤分级的比较研究作者：邹艳陆止齐杨钦泰康庄【摘要】【口的】分析同一组脑胶质瘤的MRI灌注和扩散加权图像信息，对比这两种功能成像对脑胶质瘤病理分级的诊断价值。【方法】42例(低级胶质瘤20例，高级胶质瘤22例)脑胶质瘤患者行MRI灌注及扩散加权成像，测量肿瘤实质的灌注参数和弥散参数，进行差并的I检验，采用受试者操作特征曲线(ROC曲线)确定找到诊断阈值，计算敏感性及特异性。对两种诊断方法进行评价并对诊断符合率进行?字2检验。【结果】低级胶质瘤20例，高级胶
2、质瘤22例。低级胶质瘤的rCBV,rMSD,rMTT,ADC和rADC值分别为2.25+1.07,1.82±0.70,1.07±0.08,(1.36±0」4)x10-3mm2-s-l和1.69±0.23。高级胶质瘤的rCBV,rMTT,rMSD,ADC和rADC值分别为4.83±1.84,3.36+0.88,1.04+0.06,(1.10+0.12)x10-3mm2-s-l口1.41±0.18。高级与低级胶质瘤的rCBV,rMSD,ADC和rADC值有统计学意义。以rCBV值3.5为阈值，诊断敬感度为81.8%,特异度为90%;rMSD值2.1为阈值，诊断敏感
3、度为95.5%,特界度为80%;ADC阈值为1.23x10-3mm2/s吋，诊断敏感度为86.4%,特异度为85%。通过对AUC的计算和假设检验，发现PWI和DWI诊断准确度较高，差开尢统计学意义。【结论】以PWI和DWI的rCBV值3.5、rMSD值2」、ADC值1.23x10-3mm2s-l为阈值时，均有利于鉴别胶质瘤级别。这些阈值对于评价胶质瘤的术前病理分级以及指导肿瘤的治疗和估计预后具有一定的价值。【关键词】胶质瘤；磁共振成像；灌注；扩散Abstract:[Objective]ToevaluatethevalueofMRIperfusion-weigh
4、tedimaging(PWI)anddiffusion-weightedimaging(DWI)inthegradingofgliomabycomparingtherelatedparameters.[Methods]Atotalof42(22high-gradegliomas,20low-gradegliomas)patientsverifiedgliomabypathologyunderwentDWIanddynamiccontrasted-enhancedT2*-weightedPWI.Relativecerebralbloodvolume(rCBV),
5、relativemaximumslopeofdecrease(rMSD),relativemeantransittime(rMTT),apparentdiffusioncoefficient(ADC)andADCratios(rADC)dataofhigh-gradeandlow-gradegliomasweremeasuredandtheirdifferencewasanalyzedwitht-test.Receiveroperatingcharacteristic(ROC)analyseswereperformedtodetermineoptimumthr
6、esholdsfortumorgradingandalsotocalculatethesensitivityandspecificityfortumorgrading.[Results]TherCBV,rMSD,rMTT,ADC,andrADCvaluesoflow-gradegliomaswere2.25±1.07,1.82±0.70,1.07±0.08,(1.36±0.14)x10・3mm2s・l,and1.69±0.23,respectively.TherCBV,rMTT,rMSD,ADC,andrADCvaluesoflow-gradegliomasw
7、ere4.83±1.84,3.36土0.88,1.04±0.06,(1.10±0.12)x10-3mm2s-1,and1.41±0.18,respectively.TheresultsofrCBV,rMSD,ADCandrADCwerebetweenlow-andhigh-gradegliomas(P0.0001),whiletherewasnosignificantdifferenceinrMTT.ThethresholdofrCBV,rMSD,andADCvaluewere3.5,2.1,and1.23x10-3mm2s-lrespectively,and
8、thediagnosissensibi
