CAJ | 학술논문

目的比较自主呼吸控制(ABC)辅助三维CT(3D-CT)平静吸气末和呼气末与四维CT(4D-CT)终末时相间胸上、中、下段食管位置、体积及其匹配指数(MI)的差异.方法 11例周围型肺癌患者依次完成胸部4D-CT扫描及ABC辅助平静吸气末(CTEIH)和呼气末(CTEEH) 3D-CT扫描.每个呼吸周期的4D-CT图像平均分为10个呼吸时相,0％时相定义为吸气末时相(CT0),50％时相定义为呼气末时相(CT50),分别在CT0、CT50、CTEIH和CTEEH图像上勾画胸上、中、下段食管,分别比较CT0与CTEIH间、CT50与CTEEH间胸上、中、下段食管中心点径向方向位置、体积及体积MI的差异.结果 CT0与CTEIH间胸上、中、下段食管左右(x)方向的位置差异分别为(-0.02±0.16)cm、(0.06±0.26)cm、(0.10±0.33) cm,前后(y)方向的位置差异为(0.04±0.24) cm、(0.04±0.12)cm、(0.08±0.15)cm,左右及前后方向位置差异无统计学意义.CT50与CTEEH间胸上、中、下段食管x方向的位置差异为(-0.02±0.24)cm、(0.12±0.37)cm、(0.26±0.33)cm,y方向的位置差异为(0.03 ±0.21) cm、(0.04±0.17)cm、(0.14±0.18)cm,上段和中段食管CT50与CTEEH间位置左右及前后方向差异无统计学意义,下段食管CT50与CTEEH间位置左右及前后方向差异有统计学意义(t=0.025、0.024,P＜0.05).胸上、中、下段食管体积,CT0均大于CTEIH,CT50均大于CTEEH,但差异无统计学意义.CT0与CTEIH间胸上、中、下段食管体积匹配指数(MI)分别为0.50±0.17、0.50±0.19、0.56±0.08,CT50与CTEEH间各段食管体积MI分别为0.50±0.16、0.47±0.14、0.51±0.15,CT0与CTEIH间各段食管MI大于CT50与CTEEH间,差异无统计学意义.结论呼吸模式对胸上、中段正常食管位置影响并不显著;两种呼吸模式同一状态,无论哪段食管均存在空间错位.
목적 비교자주호흡공제(ABC)보조삼유CT(3D-CT)평정흡기말화호기말여사유CT(4D-CT)종말시상간흉상、중、하단식관위치、체적급기필배지수(MI)적차이.방법 11례주위형폐암환자의차완성흉부4D-CT소묘급ABC보조평정흡기말(CTEIH)화호기말(CTEEH) 3D-CT소묘.매개호흡주기적4D-CT도상평균분위10개호흡시상,0％시상정의위흡기말시상(CT0),50％시상정의위호기말시상(CT50),분별재CT0、CT50、CTEIH화CTEEH도상상구화흉상、중、하단식관,분별비교CT0여CTEIH간、CT50여CTEEH간흉상、중、하단식관중심점경향방향위치、체적급체적MI적차이.결과 CT0여CTEIH간흉상、중、하단식관좌우(x)방향적위치차이분별위(-0.02±0.16)cm、(0.06±0.26)cm、(0.10±0.33) cm,전후(y)방향적위치차이위(0.04±0.24) cm、(0.04±0.12)cm、(0.08±0.15)cm,좌우급전후방향위치차이무통계학의의.CT50여CTEEH간흉상、중、하단식관x방향적위치차이위(-0.02±0.24)cm、(0.12±0.37)cm、(0.26±0.33)cm,y방향적위치차이위(0.03 ±0.21) cm、(0.04±0.17)cm、(0.14±0.18)cm,상단화중단식관CT50여CTEEH간위치좌우급전후방향차이무통계학의의,하단식관CT50여CTEEH간위치좌우급전후방향차이유통계학의의(t=0.025、0.024,P＜0.05).흉상、중、하단식관체적,CT0균대우CTEIH,CT50균대우CTEEH,단차이무통계학의의.CT0여CTEIH간흉상、중、하단식관체적필배지수(MI)분별위0.50±0.17、0.50±0.19、0.56±0.08,CT50여CTEEH간각단식관체적MI분별위0.50±0.16、0.47±0.14、0.51±0.15,CT0여CTEIH간각단식관MI대우CT50여CTEEH간,차이무통계학의의.결론 호흡모식대흉상、중단정상식관위치영향병불현저;량충호흡모식동일상태,무론나단식관균존재공간착위.
Objective To compare the position,volume and matching index (MI) of esophagus between quiet end-inspiration and end-expiration in three dimensional CT (3D-CT) assisted with active breathing control (ABC) and the corresponding phases in four dimensional CT (4D-CT).Methods Eleven patients with peripheral lung cancer underwent 4D-CT simulation scan and 3D-CT simulation scans in end-inspiratory hold (CTEIH) and end-expiratory hold (CTEEH) in succession.The 0％ phase was defined as end-inspiratory phase (CT0),while the 50％ phase was defined as end-expiratory phase (CT50).The proximal,mid-,and distal thoracic esophagus were delineated separately on CT0,CT50,CTEIH and CTEEH images.The position,volume and MI of each segment esophagus between CT0 and CTEIH,CT50 and CTEEH were compared.Results In the left-right (x) direction,the position differences in the proximal,mid-,and distal thoracic esophagus between CT0and CTEIH were (-0.02 ±0.16)cm,(0.06 ± 0.26)cm and (0.10 ± 0.33) cm respectively,and in the anterior-posterior (y) direction,the position differences were (0.04 ±0.24)cm,(0.04 ±0.12) cm and (0.08 ±0.15) cm respectively,and the position differences in the same direction were not statistically significant.In the x direction,the position differences of the proximal,mid-,or distal thoracic esophagus between CT50 and CTEEH were (-0.02 ±0.24) cm,(0.12 ± 0.37) cm and (0.26 ± 0.33) cm respectively,and in the y direction,the position differences were (0.03 ±0.21)cm,(0.04 ±0.17)cm and (0.14 ±0.18)cm respectively,and the position differences in x and y directions of proximal and mid-thoracic esophagus between CT50 and CTEEH were not statistically significant,while the position differences in x and y directions of distal thoracic esophagus between CT50and CTEEH were both statistically significant (t =0.025,0.024,P ＜ 0.05).The volumes of the proximal,mid-and distal thoracic esophagus were all larger in CT0and CT50 than those in CTEIHand CTEEH,but without statistical differences.The MIs of the volumes of the proximal,mid-and distal thoracic esophagus between CT0 and CTEIH were (0.50 ± 0.17),(0.50 ± 0.19) and (0.56 ± 0.08),respectively,and those between CT50and CTEEH were (0.50 ±0.16),(0.47 ±0.14) and (0.51 ±0.15),respectively.The MI of each segment esophagus between CT0and CTEIHwas larger than that between CT50 and CTEEH,but without statistical differences.Conclusions The influence of breathing modes on the centroid positions of the proximal,mid-thoracic normal esophagus were not significant and there were spatial mismatches for any segment esophagus between 3D-CT assisted with ABC and 4D-CT.