ABC辅助平静吸气末和呼气末3D-CT与4D-CT食管位置及体积比对研究  

Comparison of the position and volume of esophagus between quiet end-inspiration and end-expiration three dimensional CT assisted with active breathing control and corresponding phases in four dimensional CT

作　　者：戚焕鹏[1] 李建彬[1] 梁超前[1] 马志芳[1] 张英杰[1] 王玮[1] 邢军[1] 

机构地区：[1]山东省肿瘤医院放疗科,济南250117

出　　处：《中华放射医学与防护杂志》2013年第6期611-614,共4页Chinese Journal of Radiological Medicine and Protection

基　　金：山东省自然科学基金项目（ZR2011HM004）;山东省科技发展计划项目（2012GSF11839）

摘　　要：目的 比较自主呼吸控制（ABC）辅助三维CT（3D-CT）平静吸气末和呼气末与四维CT（4D-CT）终末时相间胸上、中、下段食管位置、体积及其匹配指数（MI）的差异。方法 11例周围型肺癌患者依次完成胸部4D-CT扫描及ABC辅助平静吸气末（CTEIH）和呼气末（CTEEH）3D-CT扫描。每个呼吸周期的4D-CT图像平均分为10个呼吸时相，0%时相定义为吸气末时相（CT0），50%时相定义为呼气末时相（CT50），分别在CT0、CT50、CTEIH和CTEEH图像上勾画胸上、中、下段食管，分别比较CT0与CTEIH间、CT50与CTEEH间胸上、中、下段食管中心点径向方向位置、体积及体积MI的差异。结果 CT0与CTEIH间胸上、中、下段食管左右（x）方向的位置差异分别为（-0.02±0.16）cm、（0.06±0.26）cm、（0.10±0.33）cm，前后（y）方向的位置差异为（0.04±0.24）cm、（0.04±0.12）cm、（0.08±0.15）cm，左右及前后方向位置差异无统计学意义。CT50与CTEEH间胸上、中、下段食管x方向的位置差异为（-0.02±0.24）cm、（0.12±0.37）cm、（0.26±0.33）cm，y方向的位置差异为（0.03±0.21）cm、（0.04±0.17）cm、（0.14±0.18）cm，上段和中段食管CT50与CTEEH间位置左右及前后方向差异无统计学意义，下段食管CT50与CTEEH间位置左右及前后方向差异有统计学意义（t=0.025、0.024，P〈0.05）。胸上、中、下段食管体积，CT0均大于CTEIH，CT50均大于CTEEH，但差异无统计学意义。CT0与CTEIH间胸上、中、下段食管体积匹配指数（MI）分别为0.50±0.17、0.50±0.19、0.56±0.08，CT50与CTEEH间各段食管体积MI分别为0.50±0.16、0.47±0.14、0.51±0.15，CT0与CTEIH间各段食管MI大于CT50与CTEEH间，差异无统计学意义。结论 呼吸模式对胸上、中段正常食管位置影响并不显著；两种呼吸模式同一状态，无论哪段食管均存在空间错位。Objective To compare the position, volume and matching index （MI） of esophagus between quiet end-inspiration and end-expiration in three dimensional CT （3D-CT） assisted with active breathing control （ABC） and the corresponding phases in four dimensional CT （4D-CT）. Methods Eleven patients with peripheral lung cancer underwent 4D-CT simulation scan and 3D-CT simulation scans in end-inspiratory hold （CTEIH） and end-expiratory hold （CTEEH） in succession. The 0% phase was defined as end-inspiratory phase （CT0）, while the 50% phase was defined as end-expiratory phase （CT50）. The proximal, mid-, and distal thoracic esophagus were delineated separately on CT0, CT50, CTEIH and CTEEH images. The position, volume and MI of each segment esophagus between CT0 and CTEIH, CT50 and CTEEH were compared. Results In the left-right （x） direction, the position differences in the proximal, mid-, and distal thoracic esophagus between CT0 and CTEIH were （-0.02±0.16）cm, （0.06±0.26）cm and （0.10±0.33）cm respectively, and in the anterior-posterior （y） direction, the position differences were （0.04±0.24）cm, （0.04±0.12）cm and （0.08±0.15）cm respectively, and the position differences in the same direction were not statistically significant. In the x direction, the position differences of the proximal, mid-, or distal thoracic esophagus between CT50 and CTEEH were （-0.02±0.24）cm, （0.12±0.37）cm and （0.26±0.33）cm respectively, and in the y direction, the position differences were （0.03±0.21）cm, （0.04±0.17）cm and （0.14±0.18）cm respectively, and the position differences in x and y directions of proximal and mid-thoracic esophagus between CT50 and CTEEH were not statistically significant, while the position differences in x and y directions of distal thoracic esophagus between CT50 and CTEEH were both statistically significant （t=0.025, 0.024, P〈0.05）. The volumes of the proximal, mid-and distal thoracic esophagus were all larger in CT0 and CT50

关 键 词：食管 自主呼吸控制 三维CT 四维CT 

分 类 号：R734.2[医药卫生—肿瘤]