李瑤華2006-07-262018-07-122006-07-262018-07-122002-07-31http://ntur.lib.ntu.edu.tw//handle/246246/25429有關以磁振掃描應用於評估原發 性或次發性肌肉與神經肌肉病症的研究到 目前為止，對於指出各種肌肉疾病的各種 病理變化型態或那種特定的肌肉疾病，並 無顯著的幫助，尤其對於各群肌肉纖維走 向的變化目前的各種傳統脈序多無幫助。 肌纖維的分佈、走向與神維纖維的分佈、 走向相當的類似，因此將擴散影像應用於 肌肉疾病是在原理上是十分可行的。 目前有關於擴散影像在肌肉疾病的應用研 究在文獻上仍然十分少見[1-4] ，值得研 究。 本研究研究組為罹患原發性或次發性肌肉 與神經肌肉病症十六歲以下兒童，疑似侵 犯前臂或小腿以上肌肉組織者，另外對照 組為因為非因肌肉疾病接受磁振掃描且在 傳統Ｔ２影像無可見訊號變化的十六歲以 下兒童；磁振掃描儀為1.5T, Magnetom Visionplus echoplanar scanner 以下各 脈序進行成像包括: 1) Single-shot echo-planar DW imaging sequence 使用 body-array 線圈。兩側肢體同時受檢。實 驗組與對照組的所有擴散影像依Stejskal and Tanner equation 得出Isotropic 擬似 擴散係數圖。就FSE with fat saturation, 擴散影像以及擬似擴散係數圖計算對比雜 訊比(CNRs) ，比較各種脈序對於病灶的 影像品質。與正常側相似的區域對比雜訊 值及對照組相當年齡個體的相似肌肉區域 量取對比雜訊值比較。 十六位研究組罹患原發性或次發 性肌肉與神經肌肉病症十六歲以下兒童磁 振掃描檢查並完成其統計分析。進一步研 究各種不同的原發或次發性肌肉疾病所具 有的不同影像上的訊號表現，了解各種肌 肉疾病發生時，肌纖維內外水份分佈的大 致情形。並可依擴散影像的變化得到肌肉 疾病的大致分類。尋找適當的切片位置所 在，預期可熟悉較高難度的四肢擴散影像 檢查如何取得較佳的影像。瞭解擬似擴散 係數圖的計算，並進一步瞭解肌肉疾病在 fast T2 影像、擴散影像與擬似擴散係數圖 的大致表現分類。Until recently, studies employing conventional magnetic resonance imaging in the primary or secondary pediatric muscle disorders still cannot help to point out the pathologic changes or specific muscular disease entity, especially for the orientatio n of muscle fibers. In effect, the structures and distribution of muscle tissues are quite similar to those of nerve tissues. Application of diffusion-weighted images to evaluate muscle disorders is quite feasible in principle. However, studies using diffusion-weighted images in muscular disorders are rarely found. This study will include 20 children under the age of 16 years, suffering from primary or secondary muscular disorder which involved proximal or mid limbs. In addition, the control group will include 10 patients who were free from signal changes on conventional T2-weighted images. All patients will receive magnetic resonance imaging with 1.5 T scanner. The following pulse sequences will be performed: 1) Single-shot echo-planar DW imaging sequence in the coronal plane, using body-array coil. Bilateral limbs will be included in the field of view. According to the Stejskal and Tanner equation, isotropic apparent diffusion coefficient maps will be derived from diffusion images. Contrast-to-noise ratios of diffusion-weighted and apparent diffusion coefficient maps were calculated. This study accomplished the statistical analysis of comparison in both study and control groups of patients. Manifestations of primary and secondary muscular disorders on fast spin-echo T2, diffusion-weighted images and apparent diffusion coefficient maps will be classified according to the signal changes. In addition, results of this study will help understand the distribution of water in the intra- and extracellular compartments. Imaging findings will help to localize the suitable location for biopsy.application/pdf198303 bytesapplication/pdfzh-TW國立臺灣大學醫學院放射線科磁振掃描擴散影像擬似擴散係數值diffusion weighted imagesapparent diffusion coefficientmagnetic resonance imagingjournal articlehttp://ntur.lib.ntu.edu.tw/bitstream/246246/25429/1/902314B002333.pdf