中华消化内镜杂志
中華消化內鏡雜誌
중화소화내경잡지
CHINESE JOURNAL OF DIGESTIVE ENDOSCOPY
2011年
1期
17-20
,共4页
裘国勤%杜向慧%俞江平%陶亚利%郑远达%罗浩杰%许亚萍%陈建祥%孙晓江%季永领
裘國勤%杜嚮慧%俞江平%陶亞利%鄭遠達%囉浩傑%許亞萍%陳建祥%孫曉江%季永領
구국근%두향혜%유강평%도아리%정원체%라호걸%허아평%진건상%손효강%계영령
食管肿瘤%腔内超声检查%体层摄影术,X线计算机%大体肿瘤靶体积%止血夹
食管腫瘤%腔內超聲檢查%體層攝影術,X線計算機%大體腫瘤靶體積%止血夾
식관종류%강내초성검사%체층섭영술,X선계산궤%대체종류파체적%지혈협
Esophageal neoplasns%Endosonography%Tomography,X-ray conputed%Gross target volume%Hemoclip
目的 探讨胸段食管鳞癌基于超声内镜检查(EUS)和基于CT勾画的大体肿瘤靶体积(GTVEUS、GTVCT)的差异.方法 2008年3月到2010年2月间连续收治的36例胸段食管鳞癌患者CT模拟定位前行EUS,在EUS确定的食管病变上下界用止血夹标记.治疗体位CT模拟定位,在定位CT片上勾画GTVCT和根据止血夹标记勾画GTVEUs.分别对纵向GTVCT和纵向GTVEUS长度(LCT、LEus)和空间位置差异进行比较.结果 LCT为(7.79±3.15)cm,LEUS为(7.42±2.72)cm,两者比较差异无统计学意义(t=0.82,P＞0.05),两者Pearson相关系数为0.61(P＜0.001).2例CT无法显示病变部位,故对其余34例进行空间位置差异比较:纵向GTVCT与纵向GTVEUS空间位置吻合度(CI)为0.79±0.18,71%(24/34)患者两者空间位置不一致.8例近端不一致,21例远端不一致.未发现与EUS放置止血夹有关的并发症.结论 超声内镜止血夹定位术安全、可靠.在胸段食管鳞癌(尤其是在浅表生长的肿瘤和黏膜下生长的肿瘤)纵向GTV定位中,超声内镜能够为CT提供额外信息.
目的 探討胸段食管鱗癌基于超聲內鏡檢查(EUS)和基于CT勾畫的大體腫瘤靶體積(GTVEUS、GTVCT)的差異.方法 2008年3月到2010年2月間連續收治的36例胸段食管鱗癌患者CT模擬定位前行EUS,在EUS確定的食管病變上下界用止血夾標記.治療體位CT模擬定位,在定位CT片上勾畫GTVCT和根據止血夾標記勾畫GTVEUs.分彆對縱嚮GTVCT和縱嚮GTVEUS長度(LCT、LEus)和空間位置差異進行比較.結果 LCT為(7.79±3.15)cm,LEUS為(7.42±2.72)cm,兩者比較差異無統計學意義(t=0.82,P＞0.05),兩者Pearson相關繫數為0.61(P＜0.001).2例CT無法顯示病變部位,故對其餘34例進行空間位置差異比較:縱嚮GTVCT與縱嚮GTVEUS空間位置吻閤度(CI)為0.79±0.18,71%(24/34)患者兩者空間位置不一緻.8例近耑不一緻,21例遠耑不一緻.未髮現與EUS放置止血夾有關的併髮癥.結論 超聲內鏡止血夾定位術安全、可靠.在胸段食管鱗癌(尤其是在淺錶生長的腫瘤和黏膜下生長的腫瘤)縱嚮GTV定位中,超聲內鏡能夠為CT提供額外信息.
목적 탐토흉단식관린암기우초성내경검사(EUS)화기우CT구화적대체종류파체적(GTVEUS、GTVCT)적차이.방법 2008년3월도2010년2월간련속수치적36례흉단식관린암환자CT모의정위전행EUS,재EUS학정적식관병변상하계용지혈협표기.치료체위CT모의정위,재정위CT편상구화GTVCT화근거지혈협표기구화GTVEUs.분별대종향GTVCT화종향GTVEUS장도(LCT、LEus)화공간위치차이진행비교.결과 LCT위(7.79±3.15)cm,LEUS위(7.42±2.72)cm,량자비교차이무통계학의의(t=0.82,P＞0.05),량자Pearson상관계수위0.61(P＜0.001).2례CT무법현시병변부위,고대기여34례진행공간위치차이비교:종향GTVCT여종향GTVEUS공간위치문합도(CI)위0.79±0.18,71%(24/34)환자량자공간위치불일치.8례근단불일치,21례원단불일치.미발현여EUS방치지혈협유관적병발증.결론 초성내경지혈협정위술안전、가고.재흉단식관린암(우기시재천표생장적종류화점막하생장적종류)종향GTV정위중,초성내경능구위CT제공액외신식.
Objective To investigate the differences of measurement of gross target volume (GTV)between endoscopic ultrasonography ( EUS )-based ( GTVEUS ) and computed tomography ( CT ) -based (GTVCT) method for thoracic esophageal squamous cell carcinoma. Methods EUS was performed on 36consecutive patients with thoracic squamous cell carcinoma, and the superior and inferior boarders of the tumor defined by EUS were marked with hemoclips. The CT planning scan was then performed with the patient in supine position, and the GTVCT and GTVEUS were contoured respectively. The lengths ( LCT and LEUS) and spatial locations of longitudinal GTVCT and GTVEUS were compared. Results The mean LCT and LEUS were (7. 79 ± 3. 15 ) cm and (7. 42 ± 2. 72) cm, respectively ( t = 0. 82, P ＞ 0. 05 ), with a correlation coefficient of 0. 61 (P ＜0. 001 ). Locations of longitudinal GTVCT and GTVEUS were compared in 34cases, with 2 excluded for invisualization on CT. The mean conformal index (CI) was (0. 79 ± 0. 18 ), and spatial variations were found in 71% patients, with 8 patients at proximal end and 21 others at distal end.There was no clip placement associated complication. Conclusion Endoscopic hemoclips placement is safe and reliable. EUS can provide additional information to CT in defining longitudinal GTV in thoracic esophageal squamous cell carcinoma, especially in superficial and submucosal carcinomas.
