DTI示踪皮质脊髓束对脑胶质瘤术后放疗方案选择的影响

发布时间：2018-03-22 12:30

本文选题：脑胶质瘤　切入点：扩散张量成像　出处：《实用医学杂志》2015年04期 　论文类型：期刊论文

【摘要】：目的:探讨磁共振扩散张量成像(diffusion tensor imaging,DTI)示踪皮质脊髓束在指导脑胶质瘤术后放疗方案中的应用价值。方法:30例脑胶质瘤术后拟行放疗患者,行常规MRI及DTI扫描。获取皮质脊髓束相关数据并与相应的MR、CT解剖图像融合,导入放疗计划系统并依此勾画靶区、危及器官及皮质脊髓束,分别采用三维适形放疗(3D-CRT)技术与调强放疗(IMRT)技术制定放疗计划并进行比较。结果:在IMRT放疗计划与3D-CRT计划均达到靶区治疗剂量及危及器官保护的情况下,IMRT放疗计划中的患者患侧、健侧皮质脊髓束所受最大辐射剂量和平均辐射剂量均低于3D-CRT放疗计划(P0.05)。结论:DTI能够明确皮质脊髓束的位置、形态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,减低皮质脊髓束所受辐射剂量,从而降低放疗后发生神经损伤的可能。
[Abstract]:Objective: to evaluate the value of magnetic resonance diffusion Zhang Liang diffusion (tensor imaging DTI) tracer of corticospinal tract in guiding postoperative radiotherapy for gliomas. Routine MRI and DTI scans were performed. Corticospinal tract data were obtained and fused with the corresponding MRCT anatomical images. The radiation planning system was introduced and the target area was delineated accordingly, thus endangering organs and corticospinal tracts. Three dimensional conformal radiotherapy (3D-CRT) technique and intensity modulated radiotherapy (IMRT) technique were used to formulate and compare the radiotherapy plan. Results: under the condition that the IMRT radiotherapy plan and the 3D-CRT plan reach the target dose and endanger the organ protection, the IMRT radiotherapy plan is developed and compared. The affected side of the patient in the row, The maximum radiation dose and average radiation dose of normal corticospinal tract were lower than that of 3D-CRT radiotherapy plan P0.05.Conclusion the location, morphology of corticospinal tract and the relationship between the location of corticospinal tract and the target area of postoperative radiotherapy for gliomas can be determined by 3D-CRT. It is helpful to make protective radiotherapy plan, reduce the radiation dose of corticospinal tract, and reduce the possibility of nerve injury after radiotherapy.
【作者单位】：宁夏医科大学总医院放射科;宁夏医科大学总医院放疗科;宁夏医科大学总医院神经外科;
【基金】：国家自然科学基金资助项目(编号:81260373) 宁夏自然科学基金项目(编号:NZ11269)
【分类号】：R739.41;R445.2

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