BOLD-fMRI用于邻近大脑初级运动皮层脑胶质瘤术后调强放疗的可行性

发布时间：2018-03-07 21:45

本文选题：神经胶质瘤　切入点：磁共振成像　出处：《中国医学影像技术》2015年02期 　论文类型：期刊论文

【摘要】：目的初步探讨BOLD-fMRI指导邻近大脑初级运动皮层(PMC)脑胶质瘤术后调强放疗(IMRT)的可行性。方法收集30例邻近PMC脑胶质瘤术后拟行放疗患者,行常规MR平扫+增强及BOLD-fMRI检查。获取PMC相关数据并与相应的MRI、CT图像融合,导入放疗计划系统并依此勾画靶区、危及器官及PMC,采用IMRT技术分别制定考虑(IMRT-PMC)与不考虑PMC(IMRT-noPMC)剂量保护的两种放疗计划并进行比较。结果IMRT-PMC与IMRTnoPMC相比较,计划靶区(PTV)的所受最大辐射剂量(Dmax)、平均辐射剂量(Dmean)及适形指数(CI)、剂量均匀性指数(HI)差异均无统计学意义(P均0.05),常规危及器官的Dmax及Dmean差异均无统计学意义(P均0.05)。IMRT-PMC计划中患侧、健侧PMC的Dmax及Dmean均明显低于IMRT-noPMC计划(P均0.05)。结论 BOLD-fMRI能够明确PMC的位置及与脑胶质瘤术后放疗靶区的关系,有助于制定保护性放疗方案,最大程度减低PMC所受辐射剂量,从而降低放疗后发生放射性损伤的可能。
[Abstract]:Objective to explore the feasibility of BOLD-fMRI guidance for postoperative intensity modulated radiotherapy (IMRT) in gliomas adjacent to primary motor cortex (PMC). Methods Thirty patients with adjacent PMC gliomas were selected for postoperative radiotherapy. Conventional Mr contrast enhancement and BOLD-fMRI examination were performed. Relevant PMC data were obtained and fused with the corresponding MRI CT images. The radiation planning system was imported into the radiotherapy planning system and the target area was delineated accordingly. In order to endanger organs and PMC, IMRT technique was used to formulate and compare the two radiotherapy plans with or without the dose protection of IMRT-PMC. Results IMRT-PMC was compared with IMRTnoPMC. There were no significant differences in maximum radiation dose, mean radiation dose (Dmean), conformal index (HI) and dose homogeneity index (HI) between the two groups. There was no significant difference in Dmax and Dmean between the two groups, and there was no significant difference in Dmax and Dmean between the two groups. The Dmax and Dmean of healthy side PMC were significantly lower than that of IMRT-noPMC plan (P < 0.05). Conclusion BOLD-fMRI can identify the location of PMC and the relationship between PMC and the target area of postoperative radiotherapy for gliomas, which is helpful to establish a protective radiotherapy scheme and to minimize the radiation dose to PMC. Thus reducing the possibility of radiation damage after radiotherapy.
【作者单位】：宁夏医科大学临床医学院;宁夏医科大学总医院放疗科;宁夏医科大学总医院放射科;宁夏颅脑疾病重点实验室;
【基金】：宁夏自然科学基金(NZ11269) 宁夏医科大学重点科研计划(XZ200804)
【分类号】：R739.41;R445.2

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