兰州大学机构库 >学院待认领
FMRI成像在宫颈癌诊断及疗效评价中的临床研究
Alternative TitleThe Clinical Studies On Functional Magnetic Resonance Imaging In Diagnosing and Evaluating Curative Effects of Cervical Cancer
叶斌强
Thesis Advisor孙鹏飞
2014-05-30
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword宫颈癌 分期 弥散加权成像 动态增强MRI 血管内皮生长因子 肿瘤抑制基因
Abstract目的 探讨常规MRI检查联合弥散加权成像(DWI)、动态对比增强MRI(DCE-MRI)在宫颈癌诊断、分期及新辅助化疗疗效评 估中的价值。 方法 宫颈癌30例,其中10例手术切除、20例行新辅助化疗,所有患者均经病理证实;正常宫颈10例作为对照研究。 1. MRI成像及图像分析 应用Siemens 3.0T磁共振扫描仪成像。新辅助化疗组分别于化疗前、化疗后1月各进行1次MRI扫描;而手术组则于术前进行1次MRI扫描.MRI扫描后将数据传输至后处理工作站.2. 病理学检查、分析 手术组术后进行病理学检查,评价病变侵犯范围,同时免疫组化检测VEGF、nm23-H1表达。   3. 统计学分析 采用SPSS18.0统计分析软件分析数据:(1)宫颈癌组织与正常组织的ADC值(t检验)、TIC曲线类型(卡方检验);(2)新辅助化疗前后ADC值(t检验)、TIC曲线类型(卡方检验);(3)宫颈癌VEGF、nm23-H1表达与ADC值、TIC曲线类型间的关系(t检验和卡方检验)。  结论 1. 宫颈癌平均ADC值低于正常宫颈;宫颈癌TIC多为I或II型,宫颈癌周围正常肌层多为IV型。因此, DWI信号强度、ADC平均值及TIC类型有助于鉴别正常宫颈与宫颈癌组织,并判断宫颈癌对宫颈肌层的侵犯。 2. 宫颈癌病理分期越高,VEGF、nm23-H1阳性表达率越高,提示VEGF、nm23-H1在宫颈癌的发展过程中发挥了正性调节作用。 3. 宫颈癌病理分级越高,ADC值越低,且治疗后ADC值较治疗前明显升高。因此,DWI、ADC值可在一定程度上反映肿瘤的病理分级及治疗疗效。   4. VEGF表达与TIC I型具有相关性,DCE-MRI一定程度上可活体评价宫颈癌的血管生成。    
Other AbstractObjective To evaluate the value of conventional MRI combined with diffusion-weighted imaging(DWI) and dynamic contrast-enhanced MRI(DCE-MRI) in diagnosing, staging and assessing neoadjuvant chemotherapy of cervical carcinoma. Methods 30 patients of cervical cancer, in which 10 patients underwent surgical resection and 20 patients received neoadjuvant chemotherapy, all patients were pathologically confirmed. And 10 patients with normal cervical were served as control group. 1. MR imaging and analysis Using Siemens 3.0T MRI scanner. MR scanning was performed on neoadjuvant chemotherapy one time respectively before and after chemotherapy. Operation group received MR scanning one time before surgery. After MR scanning, images were transmitted to the workstation.    2. Pathological examination and analysis Pathological examination was performed on operation group after surgery, then evaluating tumor invasion range. Meanwhile, detecting expressions of VEGF and nm23-H1 with immunohistochemical method.    3. Statistical analysis The data was analyzed using SPSS18.0 statistical analysis software: (1)To compare ADC values(ANOVA), TIC type(Chi-square test) between cervical cancer and normal tissue group; (2)To compare ADC values(ANOVA), TIC type (Chi-square test) before and after neoadjuvant chemotherapy; (3)To evaluate the correlation between VEGF, nm23-H1 and ADC, nm23-H1 (ANOVA or Chi-square test). Conclusion 1.ADC values in cervical cancer is lower than that in normal tissue; TIC shows mainly type-I or type-II in cervical cancer, but TIC shows mainly type-IV in normal tissue. Therefore, the signal intensity of DWI, ADC value and the type of TIC are helpful in distinguishing normal cervix with cervical cancer, and evaluating invasion of cervical muscle layer.    2.As pathological classification of cervical cancer raised, expression of VEGF and nm23-H1 increased, which suggest that both of them has positive regulation in the progression of cervical carcinoma. 3.As cervical cancer advanced pathologically, ADC value decreased gradually, but ADC value after chemotherapy increased comparing with before chemotherapy. Therefore, DWI and ADC value can partly reflect pathological classification and therapeutic effect of cervical cancer.    4.There has a correlation between VEGF and type-I TIC, DCE-MRI can evaluate tumor angiogeneses of cervical cancer in vivo.    
URL查看原文
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/224126
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
叶斌强. FMRI成像在宫颈癌诊断及疗效评价中的临床研究[D]. 兰州. 兰州大学,2014.
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