摘要
目的:应用定位CT与食管造影结合的方法,探讨食管癌病变两端在CT上的厚度,为在CT上准确勾画食管癌GTV长度提供依据。方法:接受适形调强放疗的食管鳞癌病人64例,在模拟定位机下吞钡行食管造影,参考食管镜检查,确认食管癌病变两端长度,用铅珠标记,在相同体位固定下CT扫描,逐一测量铅珠标记点层面食管壁的最大厚度。采用配对t检验、One-Way ANOVA方差分析、两独立样本t检验进行统计分析。结果:食管癌病变两端管壁厚度是1.06±0.40cm,95%可信区间0.99-1.13cm,病变起始端与病变末端管壁厚度分别是1.04±0.39cm、1.09±0.40cm(t=0.851,P=0.398)。胸上、中、下段食管癌病变两端管壁厚度分别为0.99±0.37cm、0.97±0.40cm、1.22±0.36cm(F=5.963,P=0.003)。食管癌长≤5cm、5-7cm、>7cm病变两端管壁厚度分别为0.95±0.34cm、1.16±0.40cm、1.05±0.41cm(F=2.851,P=0.062)。有外侵与无外侵食管癌病变两端管壁厚度分别为1.13±0.42cm、0.98±0.36 cm(t=2.094,P=0.038)。结论:应用定位CT与食管造影结合的方法,在CT上确定食管癌GTV长度,是解决目前CT对食管癌长度定位困难的较好方法,测量的食管癌病变两端管壁厚度值可考虑作为在CT上勾画食管癌GTV长度的参考依据。
Objective：To discuss esophageal wall thickness detected by CT and esophagram in the upper and lower bounds,provides the basis of contouring GTV on CT image for esophageal carcinoma.Methods：Sixty four patients with esophageal squamous carcinoma were enrolled in this study.All swallowed barium and took a fluoroscopy.With Esophagoscopy as a reference,the upper and lower bounds of lesions were located and marked with lead balls on the skin.After CT simulation scanned with the same position,maximum thickness of esophageal wall at marked layers were measured.Paired T-test,one-way ANOVA variance analysis and independent T-test were used for statistics analysis.Results：On both ends of lesion,the thickness of esophageal wall was 1.06 ± 0.40cm,with 95％ confidence intervals 0.99-1.13cm,while in the upper and lower bounds of lesions were 1.04 ± 0.39cm,1.09 ± 0.40cm respectively （t =0.851,P =0.398）.For upper,middle and bottom thoracic esophageal carcinoma,the thickness in the upper and lower bounds of lesions were 0.99 ± 0.37cm,0.97 ± 0.40cm and 1.22 ± 0.36cm respectively（F =5.963,P =0.003）.For subgroups of carcinoma with the length of ≤ 5 cm,5 cm-7 cm,＞ 7 cm,the thickness were 0.95 ± 0.34cm,1.16 ± 0.40cm and 1.05 ± 0.41 cm respectively （F =2.851,P =0.062）.For those with or without invasion of carcinoma,the thickness of esophageal wall were 1.13 ± 0.42cm and 0.98 ± 0.36cm respectively（t =2.094,P =0.038）.Conclusion：Combining CT with barium meal examination to detect GTV length on CT image for esophageal carcinoma is an effective approach to solve difficulties in determining the length of target in esophageal carcinoma on CT images.It proves that esophageal wall thickness measured in the upper and lower bounds may provide the basis when contouring GTV on CT image for esophageal carcinoma.
出处
《现代肿瘤医学》
CAS
2013年第11期2587-2589,共3页
Journal of Modern Oncology
