BOLD-FMRI在脑星形细胞瘤术后放疗中指导皮层运动区保护的临床应用.pdfVIP

.248. 中华放射肿瘤学杂志2014 年5 月第23 卷第3 期 Chin J Radiat Oncol ,May 2014 ,Vol. 23 ,No. 3 ·头颈部肿瘤· BOLD-FMRI 在脑星形细胞瘤术后放疗中 指导皮层运动区保护的临床应用 和鸿郭艳红王明磊夏新舍朱凯王晓东折虹 {摘要] 目的 探讨在制定脑星形细胞瘤术后放疗计划时，血氧水平依赖功能 MRI (BOLD- FMRI) 指导皮层运动区剂量保护，进而达到功能保护的临床应用价值。方法 27 例脑星形细胞瘤术 后拟行放疗者，瘤灶邻近皮层运动区，行常规 MRI 、 BOLD-FMRI 检查，以后者结果为指导将皮层运动 区信息标记于定位 CT 上，并将其作为 OAR 处理。在确保靶区投照剂量的前提下尽量减少运动区受 量，进而制定保护性计划，并与常规计划对比运动区受量。结果 保护性计划皮层运动区平均受量患 侧减少最少为O. 769毛、最多为 59.209岛、平均为 30.78% ，健侧减少最少为 23.339岛、最多为 68.30% 、 平均为48.07% 。减低程度的变异系数患侧为7 1. 41% ，健侧为 36.719毛。结论 BOLD-FMRI 在制定 脑星形细胞瘤术后放疗计划时在保证靶区治疗剂量的同时能尽量减低运动区受量，进而使相应运动 功能的保护成为可能，最终提高患者的生存质量。 [关键词] 磁共振成像; 血氧水平依赖; 脑肿瘤/放射疗法; 剂量学 Clinical application of BOLD-FMRI in guiding prot仅tion of the motor cortex during pωtoperative radiotherapy for brain astrocytoma He Hong , Gω Yanhong ， Wang Minglei , Xia Xinshe , Zhu K.αi ， Wang xi归odong ， Zhe hong. • Ningxia Medical University , Yinchuan 75α刀4 ， China Corresponding author: W;αng Xiωdong. Department 01 Radiology , General Hospital 01 Ningxia Medical University , Yinchzωn 75仪始4 , China ;Email: xd印刷@yeah. net [ Abstract 1 0均创刊 To investigate the clinical value of blood oxygen level-dependent functional m何时tic resonance imaging (BOLD-FMR I) in 伊iding the dose reduction and functional protection of the motor cortex during postoperative radiotherapy for brain astrocytoma. Methods This study included 27 brain astrocytoma patients with tumors near the motor cortex , who underwent routine MRI and BOLD-FMRI before postoperative radiotherapy. The location and scope of the motor cortex , which were acquired based on BOLD-FMRI results , were marked on positioning CT images , so that the motor cortex would be dealt with as organs at risk. The dose to the motor cortex was reduced as much as possible while ensuring the thera