放療的精髓是讓腫瘤組織受到最大劑量的照射，而周圍正常組織得到doc-免費閱讀
【正文】 2）MR掃描參數(shù)的設(shè)置仍不夠理想。進一步研究圖像發(fā)現(xiàn)，由于咽后淋巴結(jié)腫大而使正常的鼻咽黏膜與咽鼓管隆突區(qū)呈隆起性改變，根據(jù)CT圖像容易誤認為腫瘤，而MRI能將其鑒別開來，導(dǎo)致融合后所勾畫的MR靶區(qū)比CT靶區(qū)縮小約35%。Bahman E等〔1〕對鼻咽癌的影像學(xué)研究也得出同樣的結(jié)論，GTVMRI比GTVCT大40~74%。結(jié)果顯示，根據(jù)融合后所勾畫的MR靶區(qū)與 CT靶區(qū)相比在各個方向上有改變，最大的偏差見于治療中心點往后方向， MR靶區(qū)小于 CT靶區(qū), mm()；在上下(頭腳方向)，MR靶區(qū)大于 CT靶區(qū)，尤其是向下方向， mm()，而左右方向平均偏差較小，但其標準差較大，最大的標準差見于CT靶區(qū)中心點往下12mm層面的左右方向， mm。1．3 影像融合方法及靶區(qū)勾畫 將CT圖像及MRI橫斷面圖像經(jīng)網(wǎng)絡(luò)傳輸?shù)絆TP工作站，由專人負責在OTP工作站上進行MRI/CT影像融合，先采用Landmark法，選用腦干、左右視神經(jīng)、基底動脈、齒突等作為內(nèi)參考點進行粗融合，再采用Manuel法，以CT及MR圖像所重建的頭面部外輪廓作為參照體進行進一步微調(diào)匹配，融合效果由研究小組成員共同評價并確定。1．2 CT/MRI檢查 全部病例均在放射治療體位、熱塑面罩固定下行橫斷面CT增強掃描。 P=), which was caused by the different knowledge of radiation oncologists. Conclusions: (1) CTMRI maching could have an influence on tumor volume delineation in nasopharyngeal carcinoma. (2) There often exists some variation of volume delineation caused by the different knowledge of radiation oncologists. (3) CTMRI fusion could make smaller the variation of volume delineation difference caused by the different knowledge of radiation oncologists.[Key Words] CTMRI maching。方法：我院2006年2~5月接受IMRT治療的首診鼻咽癌患者6例，CT及MRI掃描后行MRI/CT影像融合，由3位經(jīng)驗豐富的高年資放療科醫(yī)師(命名為醫(yī)師1，2，3)勾畫鼻咽部GTV，每位醫(yī)生針對CT圖像(參照MRI片)及MRI/CT融合圖像先后各勾畫一個GTV，共生成18個CT圖像的GTV(CT靶區(qū))及18個MRI/CT融合圖像的GTV (MRI靶區(qū))，研究影像融合對靶區(qū)勾畫的影響。[關(guān)鍵詞] MR/CT影像融合；鼻咽癌；IMRTInfluence of CTMRI maching on tumor volume delineation in nasopharyngeal carcinomaCHEN Jianwu1, PAN Jianji2, BO Penggang2, ZHENG Wei2，ZHANG Chun2, CHEN Yunbing2, CAI Shuhua2, LIN Shaojun2, WU Junxin2. (1) Department of Radiation Oncology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, P. R. China(2)Department of Radiation Oncology, Fujian Tumor Hospital, Teaching hospital of Fujian Medical University, Fuzhou 350014 Corresponding author: PAN Jianji,Email: panjianji[Abstract] Background and Objective:IMRT has been widely used in treating nasopharyngeal carcinoma. It is very important to have an accurate volume delineation. This paper will discuss the values of CTMRI maching for tumor volume delineation in nasopharyngeal carcinoma. Methods: 6 cases with nasopharyngeal carcinoma treated in our hospital between Fe
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