本文選題：乳腺癌 + 術(shù)后放射治療��； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:研究左側(cè)乳腺癌術(shù)后放療致心臟損傷的發(fā)生情況,探討單光子發(fā)射計(jì)算機(jī)斷層掃描門(mén)控心肌灌注顯像在左乳癌術(shù)后放療致心臟損傷診斷中的價(jià)值。并且分析相關(guān)心臟毒性與劑量-體積因子的相關(guān)性。方法:對(duì)曾就診于我科的左乳癌術(shù)后放療后患者進(jìn)行隨訪,收集并篩選符合條件的患者,行~(99)Tc~m-MIBI同日法單光子發(fā)射計(jì)算機(jī)斷層掃描門(mén)控心肌灌注顯像檢查,由兩位有經(jīng)驗(yàn)的核醫(yī)學(xué)科醫(yī)師讀取運(yùn)動(dòng)+靜息心肌灌注顯像數(shù)據(jù)結(jié)果,運(yùn)用QGS/QPS軟件進(jìn)行定量分析,判斷患者是否出現(xiàn)心功能異�；蛐募」嘧⑷睋p。并對(duì)這些患者放療的劑量-體積數(shù)據(jù)進(jìn)行分析,了解心臟毒性與其是否關(guān)聯(lián)。結(jié)果:10例左乳腺癌術(shù)后放療后患者參加了這項(xiàng)研究。就本次心肌灌注顯像檢查來(lái)看,在10例中有3例出現(xiàn)了心肌灌注缺損或減低,且都位于心尖段,而同時(shí)進(jìn)行的其他心臟相關(guān)檢查并未發(fā)現(xiàn)心功能異常,因此單光子發(fā)射計(jì)算機(jī)斷層掃描門(mén)控心肌灌注顯像可作為診斷放射性心臟損傷的檢查方法。相比沒(méi)有心肌灌注缺損或減低的患者,在出現(xiàn)心肌灌注缺損或減低的患者中,V39-V41有顯著增高(p0.05),這說(shuō)明心臟高劑量受照體積百分比可能是誘發(fā)放射性心臟損傷的重要因素。結(jié)論:左乳腺癌放療可能會(huì)誘發(fā)心臟損傷。~(99)Tc~m-MIBI單光子發(fā)射計(jì)算機(jī)斷層掃描門(mén)控心肌灌注顯像檢查可以檢測(cè)放療后心臟損傷的發(fā)生。V39、V40、V41可能是誘發(fā)放射性心臟損傷的一個(gè)重要的因素。
[Abstract]:Objective: to study the incidence of cardiac injury induced by radiotherapy in patients with left breast cancer, and to evaluate the diagnostic value of single photon emission computed tomography gated myocardial perfusion imaging (SPECT) in the diagnosis of postoperative radiation-induced cardiac injury in patients with left breast cancer.The correlation between cardiac toxicity and dose-volume factor was analyzed.Methods: patients with left breast cancer who had been treated in our department after postoperative radiotherapy were followed up. The eligible patients were collected and screened, and the gated myocardial perfusion imaging was performed by single photon emission computed tomography (SPECT) on the same day.The results of exercise resting myocardial perfusion imaging were read by two experienced physicians in nuclear medicine. Quantitative analysis was carried out with QGS/QPS software to determine whether the patients had abnormal cardiac function or myocardial perfusion defect.Dose-volume data from these patients were analyzed to see if cardiac toxicity was associated with it.Results 10 patients with left breast cancer after postoperative radiotherapy participated in the study.The myocardial perfusion imaging showed that 3 of the 10 patients had myocardial perfusion defect or decrease, and all of them were located at the apical segment, while other cardiac related examinations did not show cardiac dysfunction.Therefore, single photon emission computed tomography gated myocardial perfusion imaging can be used as a diagnostic method for radiation-induced cardiac injury.Compared with those with no myocardial perfusion defect or decrease, V39-V41 was significantly increased in patients with myocardial perfusion defect or decrease, indicating that the percentage of heart irradiated volume at high dose may be an important factor in inducing radiation-induced cardiac injury.Conclusion: left breast cancer radiotherapy may induce cardiac injury. Tccm-MIBI gated myocardial perfusion imaging can be used to detect cardiac injury after radiotherapy. V39 V40V41 may be an important factor in radiation-induced cardiac injury.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R737.9

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