Dokument: Evaluation der ASL-Bildgebung und höherer mathematischer Modelle der DWI-Bildgebung in der MRT-Mammographie
| Titel: | Evaluation der ASL-Bildgebung und höherer mathematischer Modelle der DWI-Bildgebung in der MRT-Mammographie | |||||||
| URL für Lesezeichen: | https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=48075 | |||||||
| URN (NBN): | urn:nbn:de:hbz:061-20190212-105957-0 | |||||||
| Kollektion: | Dissertationen | |||||||
| Sprache: | Deutsch | |||||||
| Dokumententyp: | Wissenschaftliche Abschlussarbeiten » Dissertation | |||||||
| Medientyp: | Text | |||||||
| Autor: | Miekley, Marcel [Autor] | |||||||
| Dateien: |
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| Beitragende: | Prof. Dr. Silvia Obenauer [Gutachter] Univ.- Prof. Dr. med. Ruckhäberle, Eugen [Gutachter] | |||||||
| Dewey Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften » 610 Medizin und Gesundheit | |||||||
| Beschreibungen: | In dieser Studie wurden mit der diffusionsgewichteten Bildgebung (DWI) und der arterial spin labeling Technik (ASL) funktionelle Verfahren der Mamma-Magnetresonanztomographie (MRT) untersucht. Die Untersuchungen wurden bei Karzinompatientinnen und gesunden Probandinnen durchgeführt, bei der diffsuionsgewichteten Bildgebung wurden zudem Patientinnen mit Fibroadenomen untersucht. Die Bilder wurden an einer externen Workstation weiter analysiert.
Die untersuchten höheren mathematischen Modelle (biexponentielle ADC und Kurtosis) zur Auswertung der DWI wiesen eine teils bessere mathematische Genauigkeit (96,2%-98,4%) im Vergleich zu der bisher genutzten monoexponentiellen ADC Auswertung (97,9%) auf [1-5]. Die Sensitivität zur Unterscheidung von Karzinomen und Fibroadenomen der Brust lag bei den höheren mathematischen Modellen zwischen 88% und 91%, die Spezifität zwischen 66% und 83%. Bei der monoexponentiellen Untersuchung lagen die Sensitivität bei 97% und die Spezifität bei 75%. Die höheren mathematischen Modelle verbesserten somit nicht die diagnostische Genauigkeit bei der Unterscheidung zwischen Karzinomen und Fibroadenomen im Vergleich zur bisher angewandten monoexponentiellen DWI Auswertung. In der ASL Teilstudie konnte gezeigt werden, dass die kontrastmittelfreie Perfusionsmessung zwischen invasiv duktalen Karzinomen der Brust (88,2 ±39,5 ml/100g/min) und gesundem Drüsengewebe der Brust (24,9 ± 12,7 ml/100g/min) unterscheiden kann. Eine Unterscheidung zwischen invasiv lobulären Karzinomen der Brust (30,5 ± 4,3 ml/100g/min) und gesundem Drüsenparenchym gelang nicht. Funktionelle Verfahren in der Mammadiagnostik mittels MRT haben das Potential Untersuchungsergebnisse zu verbessern. Höhere mathematische Modelle der diffusionsgewichteten Bildgebung haben in dieser Studie keinen diagnostischen Benefit im Vergleich zu der bisher angewandten Auswertung mittels ADC-Wert. Die ASL Messungen in dieser Studie zeigen eine Unterscheidbarkeit von invasiv duktalen Karzinomen und gesundem Gewebe, nicht jedoch von invasiv lobulären Karzinomen und gesundem Gewebe. Die Ergebnisse müssten in einer größeren Studie verifiziert und auf klinische Anwendbarkeit geprüft werden.In this study functional techniques in the magnet resonanz imaging (MRI) of the breasts were examined. Diffusion weighted imaging (DWI) and arterial spin labeling (ASL) were used. The examinations were executed in patients with carcinomas and in healthy probands. Diffusion weighted imaging was also done in patients with fibroadenomas. The further analysis was done on an external workstation. The investigated higher mathematic models of DWI (biexponetial ADC and kurtosis) showed in part a higher mathematical precision (96,2%-98,4%) compared to the monoexponetial ADC which is used so far [1-5]. The sensitivity of the higher mathematical models for the differentiation of carcinomas and fibroadenomas lies from 88% to 91%, the specificity from 66% and 83%. The sensitivity and specificity of the monoexponetial ADC are 97% and 75%. Therefore the higher mathematical methods have no diagnostic benefit compared to the so far used monoexponential ADC. The ASL study showed that contrast agent free perfusion rating can differentiate between invasive ductal carcinomas (88,2 ±39,5 ml/100g/min) of the breast and healthy parenchyma of the breast (24,9 ± 12,7 ml/100g/min). The ASL was not able to make a differentiation between invasive lobular carcinomas of the breast (30,5 ± 4,3 ml/100g/min) and healthy parenchyma of the breast. Functional methods in breast MRI diagnostic have the potential to improve the results of examinations. Higher mathematic models in diffusion weighted imaging have not shown a diagnostic benefit compared to the so far used ADC analysis in diffusion weighted imaging. The ASL Analysis was able to differentiate between invasive ductal carcinomas and normal tissue but not between invasive lobular carcinomas and normal tissue. The results have to be verified in larger studies and have to show their diagnostic benefit. | |||||||
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| Lizenz: |  Urheberrechtsschutz | |||||||
| Fachbereich / Einrichtung: | Medizinische Fakultät » Institute » Institut für Diagnostische Radiologie | |||||||
| Dokument erstellt am: | 12.02.2019 | |||||||
| Dateien geändert am: | 12.02.2019 | |||||||
| Promotionsantrag am: | 11.04.2018 | |||||||
| Datum der Promotion: | 11.12.2018 |
