1∶1 DR胸片在全身放疗中的应用及质控研究  

The application and quality control of 1∶1 DR chest adiography in whole body radiotherapy

作　　者：张信起[1] 吕梦婷 杜坤隆 孙泽宇 鲍永超 张寅丰 ZHANG Xin-qi;LYU Meng-ting;DU Kun-long;SUN Ze-yu;BAO Yong-chao;ZHANG Yin-feng(Departmen of Medical Imaging,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院医学影像科

出　　处：《河北医科大学学报》2020年第1期72-76,共5页Journal of Hebei Medical University

基　　金：河北省科技计划项目(162777277);河北医科大学大学生创新性实验计划项目(USIP2018045)

摘　　要：目的探讨1∶1 DR胸片在全身放疗中应用的准确性与质量控制。方法选取符合纳入标准的47例患者行1∶1 DR胸片检查。按患者胸部的体厚(前后径)分为A、B、C 3组,A组17例(体厚H1≤20 cm);B组15例(体厚H2>20~24 cm),C组15例(体厚H3>24 cm)。根据1∶1 DR胸片肺野形状大小做一个肺挡铅,在全身放疗中对肺进行有效屏蔽。设患者胸部左右径为S1,其胸部图像两侧胸壁之间距离为S2。质控前照片打印比例为100%,质控后根据患者胸部厚度范围设置照片打印比例分别为93%、91%、89%。比较质控前后各患者的S1与S2,同时比较同一患者S2在不同呼吸状态下的变化。结果质控前A、B、C 3组胸部图像两侧胸壁距离(S2)明显大于胸部左右径(S1)(P<0.05)。质控后A、B、C 3组胸部左右径(S1)与胸部图像两侧胸壁距离(S2)差异无统计学意义(P>0.05)。同一患者深吸气屏气状态S2明显大于平静呼吸屏气状态S2(P<0.05)。结论质控后根据患者胸部厚度大小,确定胸部图像打印比例分别为93%、91%、89%,能够得到DR胸片上的肺野与其肺大小一致的DR胸片,即1∶1 DR胸片,根据其制作的肺挡铅在全身放疗中能够对肺部进行准确屏蔽,值得推广应用。Objective To investigate the accuracy and quality control of 1∶1 DR chest radiography in whole-body radiotherapy.Methods The 47 patients who met the inclusion criteria were selected for 1∶1 DR chest radiography.According to the chest body thickness(front and back diameter),the patients were divided into A,B and C 3 groups,17 in group A(body thickness H1≤20 cm),15 in group B(body thickness H2>20-24 cm),and 15 in group C(body thickness H3>24 cm).According to the shape and size of lung field in 1∶1 DR chest radiograph,a lung block was made to shield the lung effectively in whole body radiotherapy.Set the left and right diameter of the patient′s chest as S1,and the distance between two chest walls of the chest image as S2.The printing proportion of photos before quality control was 100%,after quality control,the printing proportion of photos set according to the chest thickness range of patients was 93%,91%and 89%,respectively.S1 and S2 of patients before and after quality control were compared.At the same time,the changes of S2 in the same patient under different respiratory states were compared.Results Before quality control,the distance between two sides of chest wall(S2)in group A,B and C3 was significantly greater than that in group S1(P<0.05).After quality control,there was no significant difference between left and right chest diameter(S1)and the distance between two sides of chest wall(S2)in group A,B and C(P>0.05).The deep breath holding state S2 of the same patient was significantly higher than that of the calm breath holding state S2(P<0.05).Conclusion After control,according to the thickness of the patient′s chest,the printing proportion of the chest image was determined to be 93%,91%and 89%,respectively.The DR chest film with the same lung field and lung size on the DR chest film,1∶1 DR chest film,can be obtained.The lung lead block made according to it can shield the lung accurately in the whole body radiotherapy,which is worth popularizing and applying.

关 键 词：全身照射 1∶1 DR胸片 肺挡铅 

分 类 号：R816[医药卫生—放射医学]