本文選題：神經(jīng)膠質(zhì)瘤　切入點(diǎn)：磁共振成像　出處：《中國醫(yī)學(xué)影像技術(shù)》2015年02期 　論文類型：期刊論文

【摘要】：目的初步探討B(tài)OLD-fMRI指導(dǎo)鄰近大腦初級運(yùn)動皮層(PMC)腦膠質(zhì)瘤術(shù)后調(diào)強(qiáng)放療(IMRT)的可行性。方法收集30例鄰近PMC腦膠質(zhì)瘤術(shù)后擬行放療患者,行常規(guī)MR平掃+增強(qiáng)及BOLD-fMRI檢查。獲取PMC相關(guān)數(shù)據(jù)并與相應(yīng)的MRI、CT圖像融合,導(dǎo)入放療計(jì)劃系統(tǒng)并依此勾畫靶區(qū)、危及器官及PMC,采用IMRT技術(shù)分別制定考慮(IMRT-PMC)與不考慮PMC(IMRT-noPMC)劑量保護(hù)的兩種放療計(jì)劃并進(jìn)行比較。結(jié)果IMRT-PMC與IMRTnoPMC相比較,計(jì)劃靶區(qū)(PTV)的所受最大輻射劑量(Dmax)、平均輻射劑量(Dmean)及適形指數(shù)(CI)、劑量均勻性指數(shù)(HI)差異均無統(tǒng)計(jì)學(xué)意義(P均0.05),常規(guī)危及器官的Dmax及Dmean差異均無統(tǒng)計(jì)學(xué)意義(P均0.05)。IMRT-PMC計(jì)劃中患側(cè)、健側(cè)PMC的Dmax及Dmean均明顯低于IMRT-noPMC計(jì)劃(P均0.05)。結(jié)論 BOLD-fMRI能夠明確PMC的位置及與腦膠質(zhì)瘤術(shù)后放療靶區(qū)的關(guān)系,有助于制定保護(hù)性放療方案,最大程度減低PMC所受輻射劑量,從而降低放療后發(fā)生放射性損傷的可能。
[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.
【作者單位】： 寧夏醫(yī)科大學(xué)臨床醫(yī)學(xué)院;寧夏醫(yī)科大學(xué)總醫(yī)院放療科;寧夏醫(yī)科大學(xué)總醫(yī)院放射科;寧夏顱腦疾病重點(diǎn)實(shí)驗(yàn)室;
【基金】：寧夏自然科學(xué)基金(NZ11269) 寧夏醫(yī)科大學(xué)重點(diǎn)科研計(jì)劃(XZ200804)
【分類號】：R739.41;R445.2

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