磁共振弥散加权成像在食管癌大体肿瘤靶区勾画中的应用价值
자공진미산가권성상재식관암대체종류파구구화중적응용개치
The application value of diffusion-weighted magnetic resonance imaging in gross tumor volume delineation of esophageal squamous cell carcinoma
  • 万方数据
    中华放射肿瘤学杂志 중화방사종류학잡지
    CHINESE JOURNAL OF RADIATION ONCOLOGY
    2012年 4期 343-347 ,共5页

    侯栋梁%时高峰%高献书%李雪迎%刘辉%王亚宁%李月考%王琦%刘俊峰%刘庆熠%刘月平%姚晨%周志国%乔学英

    후동량%시고봉%고헌서%리설영%류휘%왕아저%리월고%왕기%류준봉%류경습%류월평%요신%주지국%교학영

    食管肿瘤%磁共振弥散加权成像%靶区勾画 食管腫瘤%磁共振瀰散加權成像%靶區勾畫
    식관종류%자공진미산가권성상%파구구화
    Esophageal neoplasms%Diffusion-weighted magnetic resonance imaging%Target delineation
    目的 探讨磁共振弥散加权成像(DWMRI)在食管癌大体肿瘤体积(GTV)勾画中的应用价值.方法 29例行根治性食管癌切除术的食管鳞癌患者术前行常规CT、T2WI下MRI及DWMRI(弥散敏感梯度b=400、600、800 s/mm2),分别在上述3种图像上勾画GTV.测量3种方法GTV长度并与术后标本上测量的病变长度比较,以确定最佳方法和条件,并计算该条件下外扩范围满足GTV照射要求的患者比例.利用放疗计划系统的图像融合功能将不同b值下DWMRI图像与CT图像融合,验证融合图像上勾画GTV的可行性.结果 CT和T2WI下MRI图像上测量的GTV长度和标本上测量的病变长度差值分别为3.368 mm和2.84 mm;b=400、600、800 s/mm2时DWMRI图像上测量的GTV长度和标本上测量的病变长度差值分别为0.47、-0.47、-1.53 mm,其相关系数分别为0.928、0.927、0.938.DWMRI与CT图像在放疗计划系统中能很好融合,融合图像上食管癌病变两端分界清晰.结论 DWMRI能比较准确显示食管癌GTV长度和位置,利用放疗计划系统的图像融合功能可将DWMRI与CT图像进行融合并用于食管癌GTV勾画.
    목적 탐토자공진미산가권성상(DWMRI)재식관암대체종류체적(GTV)구화중적응용개치.방법 29례행근치성식관암절제술적식관린암환자술전행상규CT、T2WI하MRI급DWMRI(미산민감제도b=400、600、800 s/mm2),분별재상술3충도상상구화GTV.측량3충방법GTV장도병여술후표본상측량적병변장도비교,이학정최가방법화조건,병계산해조건하외확범위만족GTV조사요구적환자비례.이용방료계화계통적도상융합공능장불동b치하DWMRI도상여CT도상융합,험증융합도상상구화GTV적가행성.결과 CT화T2WI하MRI도상상측량적GTV장도화표본상측량적병변장도차치분별위3.368 mm화2.84 mm;b=400、600、800 s/mm2시DWMRI도상상측량적GTV장도화표본상측량적병변장도차치분별위0.47、-0.47、-1.53 mm,기상관계수분별위0.928、0.927、0.938.DWMRI여CT도상재방료계화계통중능흔호융합,융합도상상식관암병변량단분계청석.결론 DWMRI능비교준학현시식관암GTV장도화위치,이용방료계화계통적도상융합공능가장DWMRI여CT도상진행융합병용우식관암GTV구화.
    Objective To analyze the application value of diffusion-weighted magnetic resonance imaging (DWMRI) in gross tumor volume (GTV) delineation of esophageal squamous cell carcinoma (SCC).Methods Twenty-nine patients with esophageal SCC treated with radical surgery were analyzed.Routine CT scan,MRI T2-weighted and DWMRI were employed before surgery;diffusion-sensitive gradient b-values were taken 400,600 and 800 s/mm2.GTVs were delineated using CT,MRI T2-weighted images and DWMRI under different b-value images.The length of GTVs measured under different images was compared with the pathological length and confirm the most accurate imaging condition.Use radiotherapy planning system to fuse DWMRI images and CT images to investigate the possibility of delineate GTVs on fused images.Results The difference of GTV length value between CT,T2 WI images and specimen was 3.36 mm and 2.84 mm.When b =400,600 and 800 s/mm2,the difference between GTV length value on the DWMRI images and on specimen was 0.47 mm,-0.47 mm and - 1.53 mm;the correlation coefficient of the measuring esophageal lengths on DWMRI images and the pathological lengths was 0.928,0.927 and 0.938.DWMRI images and CT images could fuse accurately on radiotherapy planning system.GTV margin could.show clearly on fused images.Conclusions DWMRI images can display the esophageal carcinoma lengths and margin accurately.When DWMRI images fused with CT images,GTV margin could show clearly,it can be used to delineate GTV accurately.
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