本文選題：血氧水平依賴磁共振成像 + 視覺功能區(qū)�。� 參考：《寧夏醫(yī)科大學》2017年碩士論文

【摘要】：目的利用血氧水平依賴功能磁共振成像(blood oxygen level dependent functional magnetic resonance imaging,BOLD-fMRI)技術定位視覺功能區(qū),將其與放療系統(tǒng)定位CT融合并勾畫視覺功能區(qū),進而制定相應的保護性計劃,評價BOLD-fMRI在指導枕葉腦膠質瘤術后放射治療視覺功能區(qū)保護中的臨床應用價值。方法本研究選取本院枕葉區(qū)腦膠質瘤術后擬行放療病例28例。所有患者放療前行定位CT、常規(guī)MRI及BOLD-fMRI檢查,獲得在3D T1解剖圖像上顯示的視皮質激活圖,并以此為指導在定位CT圖像上標記視皮質區(qū),采用IMRT技術分別制定視覺功能區(qū)保護性放療計劃和未考慮視覺功能區(qū)的常規(guī)放療計劃。通過比較PTV的靶區(qū)適形度(CI)、劑量均勻性(HI)、所受最大輻射劑量(Dmax)、平均輻射劑量(Dmean)以及視覺功能區(qū)所受最大輻射劑量(Dmax)、平均輻射劑量(Dmean),評價視覺功能區(qū)保護性方案的可行性。結果常規(guī)放療計劃及視覺功能區(qū)保護性放療計劃在保護常規(guī)危及器官(Organs At Risk,OAR)及確保靶區(qū)有效治療劑量的前提下,PTV的CI及HI差異無統(tǒng)計學意義(P=0.874、0.602)。視覺功能區(qū)保護性計劃患側視皮質Dmax、Dmean分別降低8.40%、9.25%,健側13.26%、14.77%。結論利用BOLD-fMRI指導制定視覺功能區(qū)保護性放療計劃,在保證靶區(qū)處方劑量的前提下,相比常規(guī)放療計劃,降低了視覺功能區(qū)受照劑量,進而可以實現(xiàn)相應功能區(qū)保護。
[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.
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R739.41;R445.2

【參考文獻】

相關期刊論文 前10條

1 邢振;曾崢;佘德君;劉穎;黃欣瑤;熊美連;張宇陽;曹代榮;;3.0TMR多模態(tài)功能成像在膠質瘤術后復發(fā)與放射性壞死鑒別診斷中的價值[J];臨床放射學雜志;2016年09期

2 趙超云;王明磊;夏新舍;郭艷紅;劉子姍;孫勝玉;趙建國;馬輝;王曉東;夏鶴春;;腦膠質瘤術后IMRT中彌散張量成像示蹤視覺通路纖維束應用研究[J];中華放射腫瘤學雜志;2016年04期

3 張玉琴;徐海東;董海波;周進龍;;3.0T氫質子磁共振波譜成像在膠質瘤術前分級及術后隨訪中的應用[J];醫(yī)學影像學雜志;2016年02期

4 蔣華勇;王雅棣;;高級別腦膠質瘤的放療進展[J];中華放射腫瘤學雜志;2015年05期

5 楊宇;周知慧;李平;婁昕;;MRI環(huán)形強化的高級別膠質瘤的DWI信號探討[J];中國臨床醫(yī)學影像雜志;2015年01期

6 劉寧;高嵩;袁雙虎;;膠質瘤BOLD-fMRI臨床應用研究現(xiàn)狀[J];中華腫瘤防治雜志;2014年14期

7 劉波;謝惠;施武非;馮練;屈亞林;韓福剛;;3.0T MRI氫質子波譜對33例腦額葉膠質瘤的診斷價值[J];重慶醫(yī)學;2014年20期

8 易美芝;延根;張桂珊;耿寬;吳仁華;;用7.0 T ~1H MR波譜對腦膠質瘤不同部位腦代謝特征的實驗研究[J];磁共振成像;2014年03期

9 和鴻;郭艷紅;王明磊;夏新舍;朱凱;王曉東;折虹;;BOLD-FMRI在腦星形細胞瘤術后放療中指導皮層運動區(qū)保護的臨床應用[J];中華放射腫瘤學雜志;2014年03期

10 郭啟勇;辛軍;張新;于兵;趙周社;李宏利;李紅;王曉明;廖偉;;MRI水擴散加權成像分子機理研究進展[J];中國臨床醫(yī)學影像雜志;2013年07期

，

本文編號：2091851