^(125)I粒子肿瘤组织内放疗术:影像学作用与优选研究  

Iodine-125 seeds placement in tumor for interstitial brachytherapy: value and application of imageology

作　　者：钱俨[1] 杨秀军[2] 马旺扣[3] 

机构地区：[1]上海市第八人民医院肿瘤科,上海200235 [2]上海市第八人民医院放射科,上海200235 [3]上海市第八人民医院普外科,上海200235

出　　处：《中国介入影像与治疗学》2007年第1期15-18,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨125I粒子植入瘤内放疗术及影像学作用与技术优选。方法43例无法根治肿瘤患者行125I粒子组织内植入术55人次,其中CT引导6人次、小C臂透视引导6人次、内镜引导下7人次、手术直视下36人次,每次植入粒子12~46个,粒子大小4.5mm×0.8mm、活度0.5~0.8mCi、间距0.5~1.5cm。术后影像学随访1~8次共169例次,其中X线平片85例次、CT39例次、两者均查45例次。结果粒子植入术均一次成功,总有效率83.7%(36/43),无严重并发症,术后恢复自由活动时间1~3天,1天者包括所有CT引导下粒子植入者,后者均为外科手术者。平片显示粒子与植入数目一致者38例次,其中19例次需结合正侧位胸片,粒子移位3例。84例次CT显示粒子单纯瘤体内分布52例次,其中分布满意者39例次,包括所有6人次CT引导粒子植入者共15次CT检查;粒子瘤体内外分布32例次。CT准确显示了肿瘤退缩、进展情况,粒子准确计数困难,结合多平面重建图像和定位片有助于克服这一缺陷。结论125I粒子植入肿瘤组织内放疗术是癌症治疗安全有效手段之一,影像学尤其CT起到了术中引导、定位与术后随访、疗效评估的作用。Objective To investigate the techniques of radioactive Iodine-125 seeds implantation for cancer interstitial brachytherapy and to determine the value and application of imageology. Methods Fifty-five procedures of Iodine-125 seeds implantation were performed in 43 patients with 0. 5-0. 8 mCi seeds and intervals from 5 mm to 15 ram, which 7 of them guided by CT, 6 by small C-arm, 7 by endoscopy and 36 by surgery. Follow-up study by imaging were done for 159 which from 1 to 8 every case, and there were one to 612 days, mean 56 days, for the first imaging evaluation after seeds placement. Results All procedures were once successful and the total therapeutic effect was 83.7 % （36/43） without any serous complications. The period recovered from operation was lday to 3 days and that of procedure guided by CT was all one day. The seed position was partially shifted in 3 cases which was detected by X-ray plain films. And the plain accurately determined seeds number, hut distribution, in 38 cases, which needed to combine posteroanterior chest film with lateral one in 19 cases. Thirtyine CT examinations showed satisfactorily seeds distribution hut accurate seeds number, including all that implanting guided by CT and found seeds distribution outside of tumor in 32 ones. All of 84 CT examinations well depicted tumor change. Conclusion Iodine-125 seeds implantation was safe and effective for cancer interstitial brachytherapy, imageology especially CT played important role in guiding during seeds implantation and follow-up studies.

关 键 词：放射粒子 近距离放疗 体层摄影术 X线计算机 随访研究 

分 类 号：R730.5[医药卫生—肿瘤]