CAJ | 학술논문

目的：探讨胸部肿瘤调强放疗中实施两相 CT 图像融合的应用。方法：选择我院采取调强放射治疗的胸部肿瘤患者34例，患者均采取自由呼吸 CT 图像采集以及两相 CT 融合（吸气相和呼气相），分别在两种CT 图像上勾画放疗靶区，然后分别做调强放疗计划，比较两种计划靶区体积以及剂量学参数。结果：自由呼吸 CT 图像 PTVFB的平均体积为（247．52±75．26）cm3，而两相 CT 图像 PTVcom的平均体积为（179．25±73．16） cm3，两者 PTV 体积比较，差异具有统计学意义（P ＜0．05）；两种治疗计划平均剂量、95％处方剂量包含的靶区体积以及均匀性指数均无统计学差异（P ＞0．05），而两相 CT 靶区适形度指数明显优于自由呼吸 CT 的靶区适形度指数，差异具有统计学意义（P ＜0．05）；两相 CT 较自由呼吸 CT 平均肺剂量、脊髓最大剂量以及平均食管剂量显著降低，差异具有统计学意义（P ＜0．05），且两相 CT 肺 V5～V50受照射体积显著低于自由呼吸CT，差异具有统计学意义（P ＜0．05）。结论：采用两相 CT 图像融合技术对胸部肿瘤调强放疗患者进行靶区划定，能够有助于确定足够的边界，避免机体正常组织的过多照射，且实施方法简单可行。
목적：탐토흉부종류조강방료중실시량상 CT 도상융합적응용。방법：선택아원채취조강방사치료적흉부종류환자34례，환자균채취자유호흡 CT 도상채집이급량상 CT 융합（흡기상화호기상），분별재량충CT 도상상구화방료파구，연후분별주조강방료계화，비교량충계화파구체적이급제량학삼수。결과：자유호흡 CT 도상 PTVFB적평균체적위（247．52±75．26）cm3，이량상 CT 도상 PTVcom적평균체적위（179．25±73．16） cm3，량자 PTV 체적비교，차이구유통계학의의（P ＜0．05）；량충치료계화평균제량、95％처방제량포함적파구체적이급균균성지수균무통계학차이（P ＞0．05），이량상 CT 파구괄형도지수명현우우자유호흡 CT 적파구괄형도지수，차이구유통계학의의（P ＜0．05）；량상 CT 교자유호흡 CT 평균폐제량、척수최대제량이급평균식관제량현저강저，차이구유통계학의의（P ＜0．05），차량상 CT 폐 V5～V50수조사체적현저저우자유호흡CT，차이구유통계학의의（P ＜0．05）。결론：채용량상 CT 도상융합기술대흉부종류조강방료환자진행파구화정，능구유조우학정족구적변계，피면궤체정상조직적과다조사，차실시방법간단가행。
Objective:To implement the application of two -phase CT image fusion on chest tumor.Methods:To select 34 patients with chest tumor patients treated by fusion of free breathing CT image acquisition and two -phase CT(inspiratory and expiratory),respectively,in two CT images of radiotherapeutic target delineation,and then do the IMRT plan,compare planning volume and dosimetric parameters.Results:The average volume offree breathing CT im-age PTVFB was (247.52 ±75.26)cm3 ,and the average volume of two -phase CT image PTVcom is (179.25 ±73.16) cm3 ,the comparison between PTV volume,with significant difference(P <0.05).There were no statistically signifi-cant differences between the two treatment plans,average dose prescription dose contains 95% target volume and evenness index(P >0.05),and the two phase CT target region conformal target area index significantly better than free breathing CT conformal index,with significant difference(P <0.05).Phase CT is free breathing CT mean lung dose,the maximum dose of spinal cord and the average esophageal dose significantly reduced,with statistics significant differences(P <0.05),and the two phase CT lung V5 ~V50 irradiation volume was significantly lower than that of free breathing CT,with significant difference(P <0.05).Conclusion:Using two -phase CT image fusion technique for target area delineation of thoracic tumor patients with intensity modulated radiotherapy,can help to determine the ade-quate boundary,and avoid excessive exposure to normal tissue,and the implementation method is simple and feasible.