BOLD-fMRI在脑胶质瘤术后放疗视觉功能区保护中的应用

发布时间：2018-07-03 01:54

本文选题：血氧水平依赖磁共振成像 + 视觉功能区　；参考：《宁夏医科大学》2017年硕士论文

【摘要】：目的利用血氧水平依赖功能磁共振成像(blood oxygen level dependent functional magnetic resonance imaging,BOLD-fMRI)技术定位视觉功能区,将其与放疗系统定位CT融合并勾画视觉功能区,进而制定相应的保护性计划,评价BOLD-fMRI在指导枕叶脑胶质瘤术后放射治疗视觉功能区保护中的临床应用价值。方法本研究选取本院枕叶区脑胶质瘤术后拟行放疗病例28例。所有患者放疗前行定位CT、常规MRI及BOLD-fMRI检查,获得在3D T1解剖图像上显示的视皮质激活图,并以此为指导在定位CT图像上标记视皮质区,采用IMRT技术分别制定视觉功能区保护性放疗计划和未考虑视觉功能区的常规放疗计划。通过比较PTV的靶区适形度(CI)、剂量均匀性(HI)、所受最大辐射剂量(Dmax)、平均辐射剂量(Dmean)以及视觉功能区所受最大辐射剂量(Dmax)、平均辐射剂量(Dmean),评价视觉功能区保护性方案的可行性。结果常规放疗计划及视觉功能区保护性放疗计划在保护常规危及器官(Organs At Risk,OAR)及确保靶区有效治疗剂量的前提下,PTV的CI及HI差异无统计学意义(P=0.874、0.602)。视觉功能区保护性计划患侧视皮质Dmax、Dmean分别降低8.40%、9.25%,健侧13.26%、14.77%。结论利用BOLD-fMRI指导制定视觉功能区保护性放疗计划,在保证靶区处方剂量的前提下,相比常规放疗计划,降低了视觉功能区受照剂量,进而可以实现相应功能区保护。
[Abstract]:Objective to locate visual functional areas by using blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI) and BOLD-fMRI), and to integrate it with radiotherapy system and draw a visual functional area, and then formulate a corresponding protective plan to evaluate the BOLD-fMRI on occipital glioma. The clinical application value of post radiotherapy for visual functional area protection. Methods 28 cases of brain glioma in occipital lobe area were selected for radiotherapy. All patients were treated with CT, routine MRI and BOLD-fMRI examination before radiotherapy. The visual cortex stimulated images displayed on the 3D T1 anatomical images were obtained, and this was used to guide the positioning of CT images. In the visual cortex, the visual functional zone protective radiotherapy plan and the conventional radiotherapy plan without considering the visual function area were made by IMRT technique. By comparing the target conformability (CI), dose uniformity (HI), the maximum radiation dose (Dmax), the mean radiation dose (Dmean) and the maximum radiation dose (Dmax) of the visual functional area (Dmax), the PTV was compared. Mean radiation dose (Dmean) was used to evaluate the feasibility of a visual functional area protection scheme. Results there was no statistical difference between the CI and HI of PTV (P=0.874,0.602) in the protection of conventional endanger organ (Organs At Risk, OAR) and the effective therapeutic dose of the target area (P=0.874,0.602). The protective program affected the lateral visual cortex Dmax, Dmean decreased by 8.40%, 9.25%, and the healthy side was 13.26%, 14.77%. conclusion using BOLD-fMRI guidance to formulate the visual functional area protective radiotherapy plan. Under the premise of the target area prescription dosage, compared with the conventional radiotherapy plan, the visual function area was reduced, and then the corresponding functional area protection could be realized.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.41;R445.2

【参考文献】