摘要
目的探讨腹部呼吸限制下肝脏CT三期增强扫描对确定肝脏肿块个性化靶区的临床意义。方法采用热塑体膜固定使腹部呼吸受限，在3种不同呼吸状态下对10例原发或转移性肝癌患者行CT三期增强扫描，并进行肿瘤动度的CT测量。利用SPSS 10．0统计软件对实测结果与计算结果进行配对t检验。分析肝脏肿瘤放疗CT模拟定位三期增强扫描的必要性和腹部呼吸限制下不同呼吸状态扫描的可行性。结果肿瘤动度的CT测量结果为z轴方向（0．82±0．31）cm（0．5～1．2 cm），x轴方向（0．30±0．13）cm（0．0～0．5 cm），y轴方向（0．33±0．10）cm（0．2～0．6 cm）；计算结果为z轴方向（1．03±0．37）cm（0．6～2．0 cm），x轴方向（0．31±0．14）cm（0．2～0．5 cm），y轴方向（0．35±0．11）cm（0．2～0．6 cm）；比较结果显示z轴方向上的差异有统计学意义（t=0．91，P= 0．01），x轴和y轴方向上的差异无统计学意义（x轴方向t=-1．87，P=0．10，y轴方向t=0．28，P= 0．78）。结论利用热塑体膜固定限制腹部呼吸运动是切实可行的；3种不同呼吸状态下对肝脏行CT三期增强扫描对确定肝脏肿瘤个性化计划靶区具有重要的临床意义，建议推广应用。
Objective To study the clinical significance of three-phase contrast scan of spiral CT under the limit of abdominal breathing to delineate the individual gross target volume of liver lesions. Methods The movement of 10 patients with primary or metastatic liver cancer lesion was measured with liver CT contrast scan of spiral CT under the limit of abdominal breathing after fixation by thermoplastic sheet. The results measured and calculated were matched to mathmatic model supplied by Yu Yonghua with t-test by using SPSS 10.0. The final result was to show the necessity of CT simulation three phase contrast scan in liver cancer radiotherapy and the necessity of limited abdominal breathing. Results CT measurement showed ： z axis （0.82±0.31） cm （range：0.5-1.2 cm）, x axis （0.30±0.13） cm（range：0.0-0.5 cm） ,y axis （0.33±0.10） cm （range：0.2-0.6 cm）;calculation confrast with the result of liver mathmatical models, it also showed ：z axis t = 0.91,P = 0.01, supposing the movement range and the result showed significant difference in z rods while x axis（t = - 1.87 ,P =0.10） and y axis（t =0.28 ,P =0.78） ,supposing the movement range in x and y axises did not have obvious difference. Conclusions It is practical to use the thermoplastic sheet to limit the abdominal breathing. Three kinds of different breath states corresponding to three phases of contrast scan of the spiral CT of liver, which has important clinical meaning to define by delineating the individual gross target volume of lesion in the liver. This study may be adequate for general ized practice.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2007年第2期129-131,共3页
Chinese Journal of Radiation Oncology
