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目的:将CT与MR图像进行融合,比较融合前后勾画的靶区体积,探讨融合技术在放射治疗应用中的价值。方法:收集20例肺癌脑转移患者。增强CT静脉高压注射碘帕醇(30mgI/mL)造影剂,扫描层厚5mm,扫描10.6s;增强MR静脉高压注射Gd-DTPA(0.1mmol/kg体质量)显影剂,行矢状位T1WI和横断位T1WI、T2WI和FLAIR扫描,扫描参数T1WI:TR 440ms,TE 14ms;T2WI:TR 3 200ms,TE 280ms;FLAIR IR:IR 2 000ms;层厚5mm。将CT和MR图像传输至Eclipse工作站并进行CT-MR图像融合,在3种图像上分别勾画GTVCT、GTVMR和GTVCT-MR,比较3种GTV体积,并对比体外标记点法和解剖点法的融合精度。结果:GTVCT、GTVCT-MR和GTVMR体积平均值分别为(25.24±4.73)、(21.8±5.31)和(19.03±3.04)cm3,F=9.709,q=6.21,P=0.001;其中融合组勾画的GTVCT-MR准确度要明显优于CT组GTVCT,q=3.44,P<0.05;融合组GTVCT-MR体积与核磁组GTVMR体积差异无统计学意义,q=2.77,P>0.05。体外标记点法融合精度(1.39±0.64)mm要好于解剖点法(1.97±1.0)mm。结论:CT-MR融合技术能够更准确的确定肺癌脑转移瘤病灶范围;体外标记点法可减少人为误差,融合结果要好于解剖点法。
OBJECTIVE: To fuse the CT and MR images and compare the volume of the target volume outlined before and after fusion to explore the value of fusion in radiotherapy. Methods: Twenty patients with brain metastases from lung cancer were collected. Contrast enhanced CT intravenous injection of iopamidol (30mgI / mL) contrast agent, scan thickness 5mm, scan 10.6s; enhanced MR intravenous injection of Gd-DTPA (0.1mmol / kg body weight) T1WI: TR 440ms, TE 14ms; T2WI: TR 3 200ms, TE 280ms; FLAIR IR: IR 2000ms; slice thickness 5mm. The CT and MR images were transmitted to an Eclipse workstation and CT-MR images were fused. GTVCT, GTVMR and GTVCT-MR were outlined on the three images and the volumes of the three GTVs were compared, and the fusion between in vitro marker and anatomical point method was compared Accuracy. Results: The average volumes of GTVCT, GTVCT-MR and GTVMR were (25.24 ± 4.73), (21.8 ± 5.31) and (19.03 ± 3.04) cm3 respectively, F = 9.709, q = 6.21, The accuracy of GTVCT-MR was significantly better than that of CT group GTVCT, q = 3.44, P <0.05. There was no significant difference in GTVMR volume between fusion group and nuclear magnetic resonance group, q = 2.77, P> 0.05. In vitro marker fusion method (1.39 ± 0.64) mm is better than the anatomic point method (1.97 ± 1.0) mm. Conclusion: CT-MR fusion can determine the extent of brain metastases of lung cancer more accurately. In vitro marker method can reduce the human error and the fusion result is better than anatomic point method.