DTI技术示踪视束、视辐射在指导脑胶质瘤术后放疗方案选择中的应用价值  

Application value of DTI tracing the optic tract and optic radiation for the selection of postoperative radiotherapy plan of cerebral gliomas

作　　者：赵超云 夏新舍[2] 王明磊[3] 刘子姗 高文奇[1] 马辉[4] 王晓东[3] 夏鹤春[4] 

机构地区：[1]宁夏医科大学,银川750004 [2]宁夏医科大学总医院肿瘤医院放疗科,银川750004 [3]宁夏医科大学总医院放射科,银川750004 [4]宁夏医科大学总医院神经外科,银川750004

出　　处：《磁共振成像》2015年第10期739-743,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金(编号:81260373);宁夏自然科学基金(编号:NZ11269)~~

摘　　要：目的通过扩散张量成像(diffusion tensor imaging,DTI)示踪视束、视辐射,探讨其在指导脑胶质瘤术后放疗方案中的应用价值。材料与方法选取30例脑胶质瘤患者,术后拟行放疗前行常规MRI平扫、增强及DTI扫描。获取视束、视辐射的影像学信息与3D T1解剖图像融合,将融合后的3D T1图像导入放疗计划系统并与定位CT匹配,以此勾画放疗靶区、常规危及器官及视束、视辐射。利用调强放疗(intensity modulated radiation therapy,IMRT)技术与三维适形放疗(three dimensional conformal RT,3D-CRT)技术分别制定放疗方案,观察两者结果差异有无统计学意义。结果在保证靶区治疗剂量及常规危及器官保护的情况下,IMRT计划中的患者患侧、健侧视束及视辐射所受辐射剂量均低于3D-CRT放疗计划(P<0.05)。结论 DTI技术能够显示视束、视辐射与脑胶质瘤术后放疗靶区的关系,可协助选择、制定保护性放疗方案,减少视束、视辐射所受辐射剂量,从而降低放疗后发生视觉功能障碍的风险。Objective： To analyze whether the optic tract and the optic radiation showed by diffusion tensor imaging（DTI） can be used to evaluate the value in the guidance of selecting postoperative radiotherapy plan of cerebral gliomas. Materials and Methods： Thirty patients with confirmed cerebral gliomas underwent conventional and contrast-enhanced MRI and DTI before postoperative radiotherapy. In order to delineate the radiotherapy target volume, organs at risk, optic tract and optic radiation, tractography data sets was fused with correlation MR and CT anatomy image by importing it to radiotherapy planning system. The radiotherapy plans developed with intensity modulated radiation therapy（IMRT） and three- dimensional conformal radiotherapy（3D-CRT） techniques were compared. Results： Both the IMRT and the 3D-CRT plans were ensured the therapeutic dose to the target volume and conventional organs at risk had been protected. The doses patients suffered by using the IMRT plan were lower than that of the 3D-CRT plan both in affected,unaffected side optic tract and optic radiation（P〈0.05）. Conclusion： DTI can display the location, shape of the optic tract and optic radiation, and the relationship with postoperative radiotherapy target volume of cerebral gliomas, and formulate protective treatment plan to reduce the radiation dose suffered by the optic tract and optic radiation, thereby reducing the visual dysfunction risk after radiotherapy.

关 键 词：脑胶质瘤 扩散张量成像 放射治疗 视束 视辐射 剂量学 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.41[医药卫生—诊断学]