兰州大学机构库 >学院待认领
脑胶质瘤内磁敏感伪影与病理结果相关性研究
Alternative TitleThe Correlation between the Susceptibility Artifacts during Magnetic Resonance Imaging and the Pathologic Grading of Gliomas
黄鹤
Thesis Advisor何宁
2009-05-26
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword磁共振成像 脑胶质瘤 磁敏感伪影 快速小角度激发成像 快速自旋回波成像 ki-67 微血管密度
Abstract目的:研究MR成像过程中快速自旋回波(Turbo Spin Echo, TSE)和快速小角度激发成像(Fast Low Angle Shot Imaging,FLASH)序列上脑胶质瘤瘤体内出现的磁敏感伪影(Magnetic Susceptibility Artifact, MSA)与胶质瘤病理分级的相关性,分析这种影像征象的组织病理学基础,并探讨此成像技术在脑胶质瘤术前诊断及分级的临床应用价值。方法:回顾性分析60例经手术病理证实为脑胶质瘤患者的影像资料,所有患者术前均行轴位、矢状面和冠状面的MR自旋回波序列(Spin Echo, SE-T1WI)、快速自旋回波序列(TSE-T2WI)和双回波FLASH-T2*WI(TE=15、35ms)和T1WI增强扫描,各序列保证视野(Field of View,FOV)、矩阵、层厚、层间距和层面数一致。对结果进行如下处理:① 对TSE序列、双回波FLASH序列上脑胶质瘤内出现的磁敏感伪影数目、大小及及伪影最低信号噪比(Signal Noise Ratio, SNR)进行对照分析。②根据WHO2000标准将胶质瘤病理结果分为Ⅰ- Ⅳ,Pearson及Spearman等级相关检验胶质瘤WHO分级与MR常规影像征象(大小、坏死、强化、出血及瘤周水肿)的相关性,检验胶质瘤WHO分级与FLASH序列(TE=35ms,下同)上瘤体内磁敏感伪影数目、大小及SNR的相关性。并将胶质瘤WHO分级作为应变量Y, 磁敏感伪影数目、大小及SNR做为自变量X1、X2、X3, 进行Logistic回归分析。③ 胶质瘤术后标本做免疫组化染色,对肿瘤ki-67表达强度及微血管密度(Microvessel Density,MVD)进行计数,并将Ki-67分为0-+++级。检验ki-67表达强度、MVD与磁敏感伪影数目、大小及SNR的相关性。上述影像工作由三位经验丰富放射科医师执行完成,取其一致意见为最终结果,病理工作由经验丰富病理科医师完成。 结果:① TSE序列上60例胶质瘤内发现磁敏感伪影共104个,伪影平均大小为(0.27±0.03)cm,伪影最低SNR平均为(25.82±4.23)。FLASH序列(TE=15ms)上瘤内磁敏感伪影共308个,伪影平均大小为(0.51±0.06)cm,伪影最低SNR平均为(20.77±2.20 )。FLASH序列(TE=35ms)上瘤内磁敏感伪影共550个,伪影平均大小为(0.84±0.08)cm,伪影最低SNR平均为(14.87±1.88 )。各序列上瘤体内MSA数目秩和检验结果有统计学意义(χ2=21.331、P =0.010),瘤内MSA大小及SNR的ANOVA方差分析有统计学意义(F值分别为44.517和6.839、P值均<0.05)。② Pearson相关性检验显示胶质瘤WHO分级与瘤体大小、坏死及水肿无相关性(P值均大于0.05),与出血、强化模式相关系数r分别为0.606(P=0.000)和0.483(P=0.000);与瘤体内磁敏感伪影数目、大小及最低SNR均有相关性,相关系数r值分别为0.737(P=0.000)、0.624(P=0.000)和-0.528(P=0.000),胶质瘤WHO分级与瘤体内磁敏感伪影数目、大小及最低SNR的Logistic回归分析显示瘤体内磁敏感伪影数目和大小被纳入回归方程,最低SNR被剔除,方程为P=1/[1+e-(-1.496+0.939MSA数目+1.039MSA大小)]。瘤体内MSA数目和MSA大小是脑胶质瘤恶性度的风险因素,OR值分别为2.557和2.825。③ Ki-67在脑胶质瘤WHOI级组、WHOⅡ级组、WHO III级组和WHO IV级组中的阳性表达率分别为0.00%、25.00%、23.33%和36.67%, Spearman等级相关检...
Other AbstractObjective: To investigate the dependablity of the correlation between Magnetic Susceptibility Artifact in Turbo spin echo and Dual Fast Low Angle Shot Imaging with the pathologic grading of gliomas during MR imaging. To analyze the histopathological basic of this imaging signs. And discuss the value of this MR imaging technology for clinical application in gliomas’ preoperative grading and prognostic evaluation. Materials: 60 patients diagnosed as neurospongioma by histopathological examination were analyzed retrospectively, all cases were examined by MR Spin-echo T1-weighted imaging, Turbo Spin-echo T2-weighted imaging and dual Fast Low Angle Shot T2*-weighted imaging (TE=15, 35ms), all sequence parameters were set by same field of view, matrix, slice thickness, slice distance and number of slice. All data were dealed as follow procedure: ① Compare the difference of Susceptibility artifacts including number, max-diameter and SNR in tumor region between Turbo Spin-echo T2-weighted imaging and Dual FLASH T2*-weighted imaging(TE=15、35 ms) separately. ②According to the standard of WHO 2000 glioma pathology, Pathology results were divided into grade I to grade IV, the correlation between glioma grade and conventional imaging features (size, necrosis, degree of enhancement, hemorrhage and peripheral edema of tumor) were analyzed by Pearson and Spearman rank test. The relationship between Glioma grade and the features(artifact number, size and signal noise ratio) of magnetic Susceptibility Artifacts (MSA) in FLASH sequence (TE = 35ms, the same below) were compared by the same method(Pearson and Spearman rank test). Glioma grade were set as a dependent variable Y, the number of magnetic-sensitive artifacts, size and SNR as the independent variables X1, X2, X3, Logistic Regression Analysis between Y and X were processed. ③ Ki-67 expression and microvessel density (Microvessel Density, MVD) counting of Glioma were operated by Immunohistochemical staining method, ki-67 is divided into 0 – (+++) grade. the correlation between the tumor ki-67 expression、MVD and the number 、size and SNR of magnetic-sensitive artifacts were analyzed by Pearson and Spearman test, These imaging analysis were experienced by three veteran radiologists, their consensus choice was chooes as the final results, pathology task were completed by experienced general practitioners. Results: ① Total 104 focus of MSA were founded with Turbo spin echo T2 - Weighted Imaging, the average...
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Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/222959
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
黄鹤. 脑胶质瘤内磁敏感伪影与病理结果相关性研究[D]. 兰州. 兰州大学,2009.
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