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头颈部肿瘤适形放疗中视交叉的保护:CT及MR图像配准的价值

Protection of Optic Chiasm in 3 Dimensional Conformal Radiation Therapy of Head and Neck Tumor: Value of CT and MRI Registry

  • 摘要: 目的 探讨CT及MR图像配准在三维适形放疗计划中视交叉保护的价值。方法16例头颈部肿瘤拟行3DCRT前进行CT及MRI定位时,采用碘海醇与钆喷酸葡胺(Gd-DTPA)稀释液(浓度1.61 mg/ml)按体积比6∶1配制成混合液制成的标记点,并固定于面罩上作为CT和MR图像配准的标志,CT模拟定位扫描与MR扫描的参数一致。面罩上3个球体在CT及MR图像上均在同一层面显示为CT与MR图像配准成功的标准。分别在CT及MR图像上勾画视交叉的轮廓。结果面罩标记点在CT 及MRI图像上均显示清晰,无伪影。MR图像显示所有16名患者视交叉的形态:“×”形3例,“-”字形13例,“”形2例,“”形1例。CT模拟图像仅有11例显示视交叉:“-”字形3例,8例显示“”形,5例显示不清。结论碘海醇与钆喷酸葡胺(Gd-DTPA)稀释液(浓度1.61 mg/ml)以6∶1体积比配制成混合液制成的标记点可以作为CT和MR图像配准的标识点;CT与MR图像配准有助于清晰显示视交叉,有利于3DCRT放疗中视交叉的保护。

     

    Abstract: Objective To assess the value of CT and MRI registry in the protection of optic chiasm in 3 dimensional conformal therapy of head and neck tumor. Methods Sixteen cases of head and neck tumor were performed 3 dimensional conformal therapy.The marker was mixed liquor produced by iohexol and Gd-DTPA (1.61 mg/ml) with volume ratio of 6∶1.The marker was fixed on the facemask as the sign of the CT and MRI registry.Scanning parameter of CT was the same with MRI.If three markers were displayed in the same slice both on the CT and MRI,that indicated successful registry.The optic chiasm was drawed on the CT and MRI respectively. Results The markers on the facemark were clearly displayed with no artifacts.The optic chiasm were clear displayed on MRI in all 16 cases:“×” shape in 3 cases,“-” shape in 13 cases,“” shape in 2 cases and “” shape in 1 case.The CT scan showed the optic chiasm was clear in 11 cases:“-” shape in 3 cases and “” shape in 8 cases.The optic chiasm was not been seen in 5 cases. Conclusion The mixed liquor produced by iohexol and Gd-DTPA (1.61 mg/ml) with volume ratio of 6∶1 was good marker in CT and MRI registry.CT and MRI registry can display the optic chiasm clearly,which was useful to the protection of optic chiasm in 3 dimensional conformal therapy of head and neck tumor.

     

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