CT引导下125 I粒子植入治疗肺癌的能谱CT参数观察及早期疗效评价  

The Spectral CT in Evaluating the Early Effect of CT-Guided 125I Radioactive Seed Implantation for Lung Cancer

作　　者：陈健铃[1] 蔡传煜 张静[3] Chen Jianling;Cai Chuanyu;Zhang Jing(Radiotherapy Center of Fujian Tumor Hospital,Fuzhou 350014,China;Fujian Medical University Union Hospital,Fuzhou350001,China;Fujian Provincial Hospital,Fuzhou 350001)

机构地区：[1]福建省肿瘤医院放疗中心,福建福州350014 [2]福建省医科大学附属协和医院放疗科,福建福州350001 [3]福建省立医院急诊室,福建福州350001

出　　处：《哈尔滨医药》2018年第4期312-313,共2页Harbin Medical Journal

摘　　要：目的观察CT引导下125 I粒子植入治疗肺癌的能谱CT参数及早期疗效价值。方法回顾性分析我院2014年3月至2017年5月收治的64例肺癌患者临床资料,术前行能谱CT增强扫描,依据CT影像,采用治疗计划系统(TPS)计算处方剂量,在CT引导下行125 I粒子植入治疗,术后1个月行能谱CT增强扫描,获得早期动静脉期碘基物质图像、水浓度、70kev CT水平和能谱曲线斜率及术后1、2个月行胸部CT增强扫描评估疗效。结果患者治疗后早期(<1个月)动静脉期碘基值(IC)、70kev CT值、能谱曲线斜率及静脉期水基值均较治疗前明显减低,差异显著(P<0.05);患者治疗前后动脉期水基值比较差异无统计学意义(P>0.05)。术后1个月局部控制率为95.31%,术后2个月局部控制率为93.75%。结论 CT引导下125I放射粒子植入治疗肺癌疗效确切,并发症轻,能谱CT参数可反映肺癌患者病灶血供及灌注情况,有助于早期疗效评估。Objective To explore the CT parameters and early efficacy of CT guided 125 I implantation in the treatment of lung cancer.Methods The clinical data of 64 patients with lung cancer admitted in our hospital in 2014 May-2017 March were reviewed.All preoperative patients were enhanced by CT enhanced scan.According to the CT image,the treatment plan system（TPS）was used to calculate the dosage of the prescription.CT guided 125 I implantation for treatment,1 hours after operation,CT enhanced scan was performed at the first time of the operation.The images of iodine base substance,water concentration,70 kev CT level and slope of the energy spectrum curve were acquired at the early stage of arteriovenous phase.CT enhanced scan was performed at1 and 2 months after operation to evaluate the curative effect.Results After treatment of patients with early（〈1 months）,arteriovenous iodine（IC）base value and 70 kev CT value,energy spectrum slope and venous phase curve water-based values were significantly lower than before treatment,the difference was significant（P〈0.05）;there was no significant difference in arterial phase value water-based patients before and after treatment（P〉0.05）.The local control rate（CR＋PR＋SD）was 95.31% for 1 months after operation,and the local control rate of 2 months after operation was 93.75%.Conclusion CT guided 125 Iradioactive particle implantation is more effective in the treatment of lung cancer.The complications are relatively mild.The CT parameters can reflect the blood supply and perfusion of the lung cancer patients,which is helpful to the early evaluation of the curative effect.

关 键 词：能谱CT扫描 肺癌 125 I粒子 

分 类 号：R445.2[医药卫生—影像医学与核医学]