動態對比增強磁振造影在攝護線腫瘤的評估研究

前言動態對比增強磁振造影(Dynamic contrast-enhanced MRI，DCE-MRI)是一種測量腫瘤血流量、血管通透性和間質及血管內容量變化的非侵入性方法，可以反應攝護腺腫瘤的微血管生成，以及通透性等藥物動力學訊息，進而評估組織的活力與功能。定量分析模型有很多種，研究目的即為利用不同分析軟體針對同一病患的數據加以測量，評估數據的一致性。並且觀察病人接受放射線治療前後的數據有無變化。材料與方法從2013年1月到2013年12月，總共搜集30位攝護腺癌病人，除了原本的檢查序列外，皆有進行DCE-MRI序列。本院西門子1.5T MRI配備有一套軟體：Tissue 4D，是利用Tofts model來分析病患接受DCE-MRI檢查的資料，我們另外還使用另一種分析模組：mTK model加以測量。利用這兩種不同分析模組來觀看病人Ktrans是否一致。另外還針對這些接受放射腺癌的病人，追蹤治療前和治療後的DCE-MRI結果。結果利用SPSS分析兩種模式對於同一病患同樣病灶的Ktrans結果，決定係數R2 值為0.419，採用學生t檢驗( student’s t test )對這些樣本進行分析，在顯著水準α設為0.05時，p-value = 8.98×10-6，小於α值0.05，有統計上的顯著意義，代表利用這兩組分析模組分析動態對比增強磁振造影時，結果上會有差異。而病人治療後的Ktrans普遍都比治療前來得低，p-value = 0.0001，小於α值0.05，有統計上的顯著意義。結論研究中，使用Tofts model和mTK model針對同一病患的病灶做DCE-MRI的分析，結果並沒有顯示兩者有明顯的關聯，這兩者唯一的差異在於有無考慮血管內狀況。因此，推斷顯影劑在血管內流通的狀況對Ktrans值有程度上的影響。另外，藉由觀察治療前後Ktrans的升高或降低，可以了解病人的治療成效，對臨床有很大的幫助。

關鍵字

動態對比增強磁振造影；攝護腺癌

並列摘要

Introduction Dynamic contrast-enhanced MRI (DCE-MRI) involves rapid, continuous imaging during and after the administration of gadolinium-based contrast agent. The time series of images is analyzed to obtain physiological information about the microvasculature of the tissue. In this study, we observe the diversity of using two different models to analyze the same data source, and see if any variation during the period of radiotherapy. Materials and Methods From Jan. 2013 to Dec.2013 , we collect totally 30 patients with prostate cancer. All of them with DCE-MRI examination. In Chi Mei Medical Center, Siemens Avanto 1.5T MRI has a software called Tissue 4D , using Tofts model to analyze raw data. This study we bring in another model (mTK model) to analyze the same data source. Then we also track patients’ Ktrans before and after radiotherapy. Result We use SPSS to compare results of these two different models. The correlation between mTK model and Tofts model isn’t significant. The statistics shows R2 is 0.419 and p-value is 8.98×10-6. Patients’ Ktrans after radiotherapy mostly lower than before. The p-value is 0.0001, shows significant in statistics. Conclusion In our study, there exists a statistically significant difference between results of these two analysis models. Because the only diversity between them is intravascular contribution, we can assume that intravascular contribution affect the result of Ktrans. We also track patients’ Ktrans before and after radiotherapy. After radiotherapy, most patients’ Ktrans have significant decreased. This result corresponds with pharmacokinetics.

並列關鍵字

Dynamic contrast-enhanced MRI ； prostate cancer

參考文獻

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動態對比增強磁振造影在攝護線腫瘤的評估研究

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