臺灣博碩士論文加值系統

目的 藉由腦血流磁振造影檢查，可得到各種腦血流動力參數，反應出組織血流灌注
的情形。腦血流流量的量測，需要動脈輸入函數和組織對比劑濃度做解捲積計算，目前
常用來得到相對腦血流流量的方式，為奇異值分解法，但此法卻易受對比劑延遲和發散
效應影響其正確性。腦血流體積可由計算組織對比劑濃度-時間曲線下的面積，或曲線
擬合得到，再以中央體積定理算得平均穿流時間。本實驗的目的是(1)降低對比劑延遲
效應對奇異值分解法的影響，(2)比較不同方法得到的相對腦血流體積，(3)比較不同計
算方法對相對平均穿流時間可能造成的影響。
方法 利用曲線擬合和計算濃度曲線面積的方法得到相對腦血流體積；並以標準奇異
值分解法、環狀奇異值分解法、和調整對比劑到達時間配合標準奇異值分解法，估計相
對腦血流流量；再依中央體積定理得到對比劑的相對平均穿流時間。將各血流動力參數
的圖像繪出比較，並圈選目標區域，顯示區域中的平均參數數值以供比較。
結果 不同的相對腦血流體積計算方式，對正常受試者影像影響不大，但若影像上各
組織體素的對比劑到達時間差異大，便會造成計算濃度曲線面積方式所得結果高估或低
估。對延遲效應不敏感的解捲積法：環狀奇異值分解法、和調整對比劑到達時間配合標
準奇異值分解法，算得的相對平均穿流時間圖像的相對性類似，但環狀奇異值分解法的
腦血流流量是普遍高估的。
結論 (1)本實驗所採用的曲線擬合方法，可直接得到腦血流體積，及對比劑到達時
間，免去複雜計算且只考慮對比劑第一次穿流，符合指示劑稀釋定理的假設。(2)環狀
奇異值分解法與調整對比劑到達時間的方法，均可改善使用標準奇異值分解法時，對比
劑延遲造成相對腦血流流量的低估情形。

中文摘要.................................. i
英文摘要.................................. ii
目錄...................................... iii
圖表目錄.................................. v
1 序論
1.1 前言.................................. 1-1
1.2 研究動機.............................. 1-3
1.3 研究架構.............................. 1-7
2 腦血流動力參數
2.1 指示劑稀釋定理........................ 2-3
2.1.1 假設................................ 2-3
2.1.2 在系統出口處量測.................... 2-7
2.2 利用DSC-MRI量測腦血流動力參數......... 2-8
2.2.1 將量測到的訊號變化轉換成對比劑
濃度資訊 ........................ 2-8
2.2.2 計算血流動力參數.................. 2-10
2.3 獨立成份分析法（測量AIF, CA(t)） . 2-14
2.4 曲線擬合（計算rCBV） ............. 2-16
2.4.1 對濃度時間曲線做曲線擬合............. 2-16
2.4.2 對訊號時間曲線做曲線擬合............. 2-18
2.4.3 擬合方法............................. 2-20
3 奇異值分解法
(Singular Value Decomposition, SVD)
3.1 標準奇異值分解法(Standard SVD, sSVD) .................................. 3-1
3.1.1 model dependent (analytical)
deconvolution ................ 3-1
3.1.2 model independent (nonpharametric)
deconvolution ................ 3-2
3.2 環狀奇異值分解法(Circulant SVD, cSVD)
與調節振盪環狀奇異值分解法
(Oscillation SVD, oSVD) .......... 3-6
3.3 延遲時間調節併奇異值分解法(Bahn+sSVD) .................................. 3-9
3.4 以模擬曲線解捲積.................. 3-9
4 實驗方法與流程
4.1 實驗設備.......................... 4-1
4.2 實驗流程及步驟.................... 4-2
4.2.1 臨床腦血流灌注檢查與影像之取得.... 4-2
4.2.2 臨床血流灌注之影像分析............. 4-4
4.2.3 實驗步驟........................... 4-5
5 實驗結果
5.1 正常受試者分析結果...................... 5-1
5.2 臨床影像分析結果................... 5-4
5.2.1 臨床病例一......................... 5-4
5.2.2 臨床病例二......................... 5-6
6 討論與結論
6.1 討論............................... 6-1
6.2 結論............................... 6-6
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