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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 趙福杉(Fu-Shan Jaw) | |
| dc.contributor.author | Cheng-Ta Yang | en |
| dc.contributor.author | 楊政達 | zh_TW |
| dc.date.accessioned | 2021-06-16T09:59:36Z | - |
| dc.date.available | 2019-02-08 | |
| dc.date.copyright | 2017-02-08 | |
| dc.date.issued | 2016 | |
| dc.date.submitted | 2016-11-28 | |
| dc.identifier.citation | 1. Andrews NC, Schmidt PJ. Iron homeostasis. Annu Rev Physiol 2007;69:69-85
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The role of magnetic susceptibility in magnetic resonance imaging: MRI magnetic compatibility of the first and second kinds. Med Phys 1996;23:815-850 57. Brittenham GM, Farrell DE, Harris JW, et al. Magnetic-susceptibility measurement of human iron stores. N Engl J Med 1982;307:1671-1675 58. Carneiro AA, Fernandes JP, de Araujo DB, et al. Liver iron concentration evaluated by two magnetic methods: magnetic resonance imaging and magnetic susceptometry. Magn Reson Med 2005;54:122-128 59. Avrin WF, Kumar S. Noninvasive liver-iron measurements with a room-temperature susceptometer. Physiol Meas 2007;28:349-361 60. Gandon Y, Olivie D, Guyader D, et al. Non-invasive assessment of hepatic iron stores by MRI. Lancet 2004;363:357-362 61. Rofsky NM, Fleishaker H. CT and MRI of diffuse liver disease. Semin Ultrasound CT MR 1995;16:16-33 62. Mortele KJ, Ros PR. Imaging of diffuse liver disease. Semin Liver Dis 2001;21:195-212 63. Fischer MA, Reiner CS, Raptis D, et al. 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Use of fat suppression in R(2) relaxometry with MRI for the quantification of tissue iron overload in beta-thalassemic patients. Magn Reson Imaging 2012;30:926-933 71. Wood JC, Ghugre N. Magnetic resonance imaging assessment of excess iron in thalassemia, sickle cell disease and other iron overload diseases. Hemoglobin 2008;32:85-96 72. Bulte JW, Miller GF, Vymazal J, Brooks RA, Frank JA. Hepatic hemosiderosis in non-human primates: quantification of liver iron using different field strengths. Magn Reson Med 1997;37:530-536 73. Clark PR, Chua-anusorn W, St Pierre TG. Bi-exponential proton transverse relaxation rate (R2) image analysis using RF field intensity-weighted spin density projection: potential for R2 measurement of iron-loaded liver. Magn Reson Imaging 2003;21:519-530 74. Israel J, Unger E, Buetow K, et al. Correlation between liver iron content and magnetic resonance imaging in rats. Magn Reson Imaging 1989;7:629-634 75. Kaltwasser JP, Gottschalk R, Schalk KP, Hartl W. Non-invasive quantitation of liver iron-overload by magnetic resonance imaging. Br J Haematol 1990;74:360-363 76. Dixon RM, Styles P, al-Refaie FN, et al. Assessment of hepatic iron overload in thalassemic patients by magnetic resonance spectroscopy. Hepatology 1994;19:904-910 77. Wang ZJ, Haselgrove JC, Martin MB, et al. Evaluation of iron overload by single voxel MRS measurement of liver T2. J Magn Reson Imaging 2002;15:395-400 78. Pavitt HL, Aydinok Y, El-Beshlawy A, et al. The effect of reducing repetition time TR on the measurement of liver R2 for the purpose of measuring liver iron concentration. Magn Reson Med 2011;65:1346-1351 79. St Pierre TG, El-Beshlawy A, Elalfy M, et al. Multicenter validation of spin-density projection-assisted R2-MRI for the noninvasive measurement of liver iron concentration. Magn Reson Med 2013 80. Hernando D, Kramer JH, Reeder SB. Multipeak fat-corrected complex R2* relaxometry: theory, optimization, and clinical validation. 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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/60153 | - |
| dc.description.abstract | 地中海型貧血的病人，需要終生的輸血，因而容易導致在身體器官的鐵質過度沉積。這些鐵質沉積主要發生於肝臟。利用原子吸收光譜儀去測定肝臟活體切片，是目前定量肝中鐵濃度最準的方法。在過去幾年中，核磁共振提供一種非侵入性的測量方法，有逐漸取代活體切片的趨勢。但是，傳統核磁共振序列(MEMPSE)的缺點為掃描時間過長。因此我們提出一種新的核磁共振序列(BHMEMPSE)，此序列在人體掃描只需要四分鐘，希望能取代傳統做法。
在本論文的第一部份，我們將不同濃度的FeCl3水溶液，用三種不同的核磁共振序列(MEMPSE，BHMEMPSE，gradient echo)掃描，發現掃描後計算出的R2/R2*數值，與FeCl3水溶液的鐵濃度呈現線性關係(在0.01 ~ 0.5 mg Fe/g的範圍內)。這個範圍相當於R2/R2*介於3 ~ 220 1/s中，適用於臨床病人的肝中鐵濃度測量。在曲線配適模型中，我們也發現mono-exponential curve fitting model是最好也最實用的方式。本論文第二部分為病人的核磁共振掃描，我們發現BHMEMPSE和MEMPSE呈現線性關係，雖然新的核磁共振序列(BHMEMPSE)的影像比較模糊，但是利用ROI圈選測量R2的方式依然可行。 | zh_TW |
| dc.description.abstract | In thalassemia patients, lifelong blood transfusion leads to iron overload in vital organs. Excess iron are mainly stored in the liver. The estimation of iron by atomic absorption spectroscopy in liver biopsy is the gold standard for the assessment of iron overload. In the last decade MR has been developed to replace liver biopsy and serve as an alternative non-invasive method for quantification of liver iron. However, traditional multiple spin-echo sequence has the disadvantage of long scanning time. Therefore, we proposed a new breath-hold multi-echo multi-planar spin echo (BHMEMPSE) sequence, which only takes 4 minutes in human study, to assess liver iron content.
In the first part, we scanned the calibrated iron solution phantom with MEMPSE, BHMEMPSE and gradient-echo sequences. These three sequences demonstrated linear trend of R2/R2* against different concentrations of iron solution, in the range of 0.01 ~ 0.5 mg Fe/g FeCl3 solution. This range corresponds to R2/R2* range of 3 ~ 220 1/s, which is wide enough for routine clinical use. We also determined that mono-exponential curve fitting model was the best one, which was more practical for clinical use. In the second part, we demonstrated the excellent linear relationship of the BHMEMPSE sequence to the MEMPSE sequence in human study. Although the anatomic details of the BHMEMPSE images were vaguely seen, drawing a circular region of interest within the liver for R2 measurement was feasible. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-16T09:59:36Z (GMT). No. of bitstreams: 1 ntu-105-D01548001-1.pdf: 1421841 bytes, checksum: 05bdd56a179da082a90a97030e47b1b6 (MD5) Previous issue date: 2016 | en |
| dc.description.tableofcontents | 致謝 .................................................. i
ABSTRACT ............................................. ii 中文摘要 ............................................. iii CONTENTS ............................................. iv LIST OF FIGURES ..................................... vii LIST OF TABLES ..................................... viii Chapter 1 Introduction .............................- 1 - 1.1 Pathophysiology of iron overload ..............- 1 - 1.2 Mechanism of iron overload ....................- 2 - 1.2.1 Chronic blood transfusion ..................- 2 - 1.2.2 Increased intestinal absorption ............- 4 - 1.2.3 Chronic liver disease ......................- 4 - 1.3 Treatment of iron overload ....................- 5 - 1.3.1 Deferoxamine ...............................- 6 - 1.3.2 Oral chelators - Deferiprone and Deferasirox ....................................................- 6 - Chapter 2 Quantification of liver iron content .....- 8 - 2.1 Need for liver iron quantification ............- 8 - 2.2 Liver biopsy ..................................- 9 - 2.3 Serum markers ................................- 10 - 2.4 Biomagnetic susceptometry ....................- 11 - 2.5 Ultrasound ...................................- 14 - 2.6 Computed tomography ..........................- 14 - 2.7 MR-based quantification methods of liver iron content ...........................................- 17 - 2.7.1 R2 relaxometry techniques .................- 17 - 2.7.1.1 Pulse sequence design ..................- 17 - 2.7.1.2 Choice of TE ...........................- 18 - 2.7.1.3 R2 estimation signal model .............- 18 - 2.7.1.4 Existing MRI-based methods and calibration ...................................................- 19 - 2.7.1.5 Limitation .............................- 23 - 2.7.2 R2* relaxometry techniques ................- 23 - 2.7.2.1 Pulse sequence design ..................- 24 - 2.7.2.2 Choice of TE ...........................- 24 - 2.7.2.3 Status of development and validation ...- 25 - 2.7.2.4 Field strength dependence of R2* .......- 27 - 2.7.2.5 Limitation .............................- 27 - 2.7.3 Signal intensity ratio techniques .........- 27 - Chapter 3 A new MR sequence for assessing liver iron content - phantom study ...........................- 30 - 3.1 Introduction and study purpose ...............- 30 - 3.2 Material and method ..........................- 31 - 3.2.1 Aqueous iron solutions ....................- 31 - 3.2.2 MRI measurements ..........................- 32 - 3.2.3 Curve fitting models ......................- 34 - 3.3 Results ......................................- 36 - 3.3.1 Comparison of three curve fitting models ..- 36 - 3.3.2 Comparison among MEMPSE, BHMEMPSE and gradient-echo imaging .............................- 41 - 3.3.3 Comparison between MEMPSE with 5 TEs and 8 TEs ...................................................- 44 - 3.4 Discussion ...................................- 46 - Chapter 4 A 4-minute breath-hold MR sequence for assessing liver iron content – patients study .....- 49 - 4.1 Introduction and study purpose ...............- 49 - 4.2 Material and method ..........................- 51 - 4.2.1 Patients study ............................- 51 - 4.2.2 MRI sequences and R2 measurement in patients ...................................................- 52 - 4.2.3 Reproducibility analysis ..................- 56 - 4.2.4 Statistical analysis ......................- 56 - 4.3 Results ......................................- 58 - 4.3.1 Patient profile ...........................- 58 - 4.3.2 Measurement of liver R2 by using the MEMPSE and BHMEMPSE sequences ................................- 59 - 4.3.3 Intra- and inter-observer agreement .......- 63 - 4.4 Discussion ...................................- 63 - Chapter 5 Conclusion ..............................- 69 - Chapter 6 References ..............................- 72 - Chapter 7 Appendix ................................- 80 - | |
| dc.language.iso | en | |
| dc.subject | 鐵質沉積 | zh_TW |
| dc.subject | 核磁共振 | zh_TW |
| dc.subject | 地中海型貧血 | zh_TW |
| dc.subject | 肝臟 | zh_TW |
| dc.subject | liver | en |
| dc.subject | iron overload | en |
| dc.subject | magnetic resonance imaging | en |
| dc.subject | thalassemia | en |
| dc.title | 利用核磁共振定量肝中鐵濃度於地中海型貧血患者 | zh_TW |
| dc.title | Quantification of Liver Iron with Magnetic Resonance Imaging in Thalassemia Patients | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 105-1 | |
| dc.description.degree | 博士 | |
| dc.contributor.coadvisor | 彭信逢(Steven Shinn-Forng Peng) | |
| dc.contributor.oralexamcommittee | 黃基礎(Ji-Chuu Hwang),施庭芳(Tiffany Ting-Fang Shih),陳邦斌(Bang-Bin Chen) | |
| dc.subject.keyword | 鐵質沉積,肝臟,核磁共振,地中海型貧血, | zh_TW |
| dc.subject.keyword | iron overload,liver,magnetic resonance imaging,thalassemia, | en |
| dc.relation.page | 86 | |
| dc.identifier.doi | 10.6342/NTU201603762 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2016-11-28 | |
| dc.contributor.author-college | 工學院 | zh_TW |
| dc.contributor.author-dept | 醫學工程學研究所 | zh_TW |
| 顯示於系所單位： | 醫學工程學研究所 | |
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| ntu-105-1.pdf 未授權公開取用 | 1.39 MB | Adobe PDF |
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