食管癌放疗前CT扫描的临床价值：附165例初步分析

探讨食管癌放疗前ＣＴ扫描的临床价值。材料与方法：１６５例食管癌放疗作了ＣＴ扫描，对病变长度，软组织影最大宽度进行了测量，对异常肿大的淋吉，受侵部位逐一记录。结果：表明病灶越长度软组织影最大宽度平均值比值增大。病变〈５ｃｍ，软组织影最大宽度平均值为３．１２，５－７ｃｍ为４．０３，７．１－９ｃｍ为５．０９；〉９ｃｍ为５．６１。淋巴结转移占３５．１５％，外侵占８９．７％，外侵常累及的部位气管占５５．１５     

食管癌放疗前CT扫描的结果分析：附165例初步分析

目的 探讨食管痛CT扫描对放射治疗的指导作用。方法 165例食管痛患者放疗前作了CT扫描,对病变部位,长度、纵隔软组织影最大宽度、异常肿大的淋巴结、受侵部位逐一记录并综合分析。结果 病变越长,软组织影最大宽度增大;淋巴结转移占35.15％(58/165),外侵占87.27％(144/165)。结论 食管癌放疗前应常规作CT扫描以明确放疗范围:病变长度、宽度、转移淋巴结、外侵部位,且CT片可直接输入“T.P.S”(Treatmant Planning System)进行放疗计划的设计、优化。     

CT扫描对食管癌诊断治疗的价值(附115例报告)

本文对我院行CT检查的115例食管癌的CT征象进行分析。探讨CT扫描对诊断食管癌及指导治疗和预后预测的价值。     

CT扫描对食管癌诊断治疗的价值（附115例分析）

本对我院行CT检查和115例食管癌的CT征象进行分析，探讨CT扫描对诊断食管癌及指导治疗和预后预测的价值。     

CT增强剂对食管癌三维适形放疗剂量分布的影响

目的探讨CT增强剂对食管癌靶区及各危及器官剂量分布的影响。方法选择食管癌患者10例,分别采集CT平扫和CT增强扫描的断层图像,然后将图像传入计划系统。分别在增强CT上勾画靶区、危及器官和设计三维适形放疗计划,并将勾画轮廓及计划复制到CT平扫上重新计算。对2套计划得出的剂量分布进行对比分析。结果靶区在D2%、D50%、D95%、D98%、Body95%、CI和HI方面的差异无统计学意义。危及器官肺V5、V20及Dmean;心脏V40及Dmean;脊髓最大剂量两者之间无统计学差异。Body、PTV、肺、心脏的CT值和电子密度在增强时高,差异有统计学意义。结论静脉注射造影剂对食管癌三维适形放疗剂量分布的影响很小,临床上可以接受这样的误差。     

复发食管癌52例放疗的临床分析

目的探讨食管癌复发好发部位、三维适形放疗疗效、生存期及预后相关因素,为临床治疗方案的制定提供依据。方法回顾性分析局部区域复发的食管癌52例,K—M方法统计患者生存、COX回归法进行单因素分析、多因素分析、卡方检验分析组间差异。结果食管癌局部区域最好发部位为吻合口、气管食管沟。经放疗后中位生存期为12个月,1年生存率为48％。单因素分析发现,复发放疗后生存期与年龄、放疗剂量、复发部位、复发转移的区域数量、术后接受辅助放疗、复发放疗后接受化疗有关。结论复发后放疗可以缓解症状、延长生存;年轻、复发期别较早者,适当提高放疗剂量并辅以化疗,可以获得较长生存期。     

CT扫描意外发现的胃部肿瘤(附12例分析)

本文收集了12例临床无典型胃病史,因其它原因进行腹部CT扫描意外发现胃部肿瘤。后经手术胃镜、活检证实诊断。CT扫描早于其它方法诊断胃部肿瘤,并具有特殊的CT征象,提示CT扫描对胃肿瘤诊断具有一定的意义。     

18F-FDG PET和CT对食管癌临床分期的价值

评价18F-FDG PET和CT判定食管癌术前T、N分期的敏感性、特异性及准确性,并探讨SUV值与食管癌预后的相关性。方法:29例食管癌患者术前均行PET和CT扫描,分别进行T、N分期,并与术后病理分期进行对照分析。结果:与术后病理证实的T、N分期结果比较,CT扫描对判断T分期的准确率明显高于PET,PET扫描对判断N分期的准确率虽高于CT,但差异无统计学意义。仅术前PET扫描检测T分期的一致性较差（Kappa<0.4）;术前PET扫描检测N分期、术前CT扫描检测T、N分期一致性均较好（Kappa>0.4）。SUV值与PETsuv2.5显示病变长度及体积呈正相关,SUV值<9.0患者预后好于SUV值≥9.0患者。结论:在判断食管癌临床T分期方面CT较PET具有一定优势,对判断N分期方面,两者准确率均较高。SUV临界值9.0可以作为一项实用的判断预后指标。      

食管癌放疗后期补充腔内放疗的价值探讨

食管癌放疗后期补充腔内放疗的价值探讨赵国旗，张锡珍为探讨在食管癌高剂量外照射后期补充高剂量率腔内放疗的价值，我们从１９９１年１月至１９９３年２月进行了一项前瞻性随机对照研究，现报告研究结果。材料与方法：病人分组及临床资料见表１。外照射用６０Ｃｏ俯卧位...     

食管癌CT检查的临床价值：附20例初步分析

食管癌ＣＴ检查的临床价值（附２０例初步分析）浙江医科大学附属第一医院放射科（３１０００３）陈正英，林兴旺，彭志毅，章熙道食管癌的ＣＴ检查国内运用不多。对于食管癌周边浸润标准不一，国内的报道也不多见。本文总结我院１９９１年７月到１９９２年７月中２０例经...     

Evaluation of Ultra-low-dose Paediatric Cone-beam Computed Tomography for Image-guided Radiotherapy

AimsIn image-guided radiotherapy, daily cone-beam computed tomography (CBCT) is rarely applied to children due to concerns over imaging dose. Simulating low-dose CBCT can aid clinical protocol design by allowing visualisation of new scan protocols in patients without delivering additional dose. This work simulated ultra-low-dose CBCT and evaluated its use for paediatric image-guided radiotherapy by assessment of image registration accuracy and visual image quality.Materials and methodsUltra-low-dose CBCT was simulated by adding the appropriate amount of noise to projection images prior to reconstruction. This simulation was validated in phantoms before application to paediatric patient data. Scans from 20 patients acquired at our current clinical protocol (0.8 mGy) were simulated for a range of ultra-low doses (0.5, 0.4, 0.2 and 0.125 mGy) creating 100 scans in total. Automatic registration accuracy was assessed in all 100 scans. Inter-observer registration variation was next assessed for a subset of 40 scans (five scans at each simulated dose and 20 scans at the current clinical protocol). This subset was assessed for visual image quality by Likert scale grading of registration performance and visibility of target coverage, organs at risk, soft-tissue structures and bony anatomy.ResultsSimulated and acquired phantom scans were in excellent agreement. For patient scans, bony atomy registration discrepancies for ultra-low-dose scans fell within 2 mm (translation) and 1° (rotation) compared with the current clinical protocol, with excellent inter-observer agreement. Soft-tissue registration showed large discrepancies. Bone visualisation and registration performance reached over 75% acceptability (rated ‘well’ or ‘very well’) down to the lowest doses. Soft-tissue visualisation did not reach this threshold for any dose.ConclusionUltra-low-dose CBCT was accurately simulated and evaluated in patient data. Patient scans simulated down to 0.125 mGy were appropriate for bony anatomy set-up. The large dose reduction could allow for more frequent (e.g. daily) image guidance and, hence, more accurate set-up for paediatric radiotherapy.     

胆囊癌的CT诊断

报道１６例原发性胆囊癌。根据其ＣＴ表现分为：囊壁增厚型３例；腔内结节型６例；肿块型６例和混合型１例。胆囊癌多种多样的ＣＴ表现取决于它在进展中不同阶段的病理改变。ＣＴ能有效显示胆囊癌对相邻脏器的侵犯、淋巴结转移和肝转移，当出现上述征象时强烈支持胆囊癌的诊断。本文还对胆囊癌的临床特点以及鉴别诊断问题进行了讨论。     

锥形束CT在肿瘤精确放疗中的应用

锥形束CT是图像引导放疗的一种方式,具有多种优势,在精确放疗中发挥了重要作用。本文就锥形束CT的基本原理、在放疗中的应用情况、研究进展进行综述。     

Detection of Nodular Lesions in the Lung Using Helical Computed Tomography: Comparison of Fast Couch Speed Technique with Conventional Computed Tomography

The present study assessed the ability of helical CT performedat fast couch speeds (20 mm or 25 mm/sec), sufficient to coverthe entire lung field during a single breath hold, comparedwith conventional CT for detecting pulmonary nodules in patientswith metastatic lung disease. The subjects were seven consecutivepatients with metastatic lung tumors in whom 152 lesions weredetected by conventional CT. The average diameter of the noduleswas 8.3 (range 2–23 mm). To scan the entire lung, we firstemployed conventional CT (10-mm slice thickness, 10 mm couchtopslide). We then used helical CT with couchtop speeds of 20 and25 mm/sec, permitting easy scanning of the entire lung fieldduring a single breath hold (images of reconstruction intervals;25, 20, 12.5 and 10 mm). We assessed each image to compare detectioncapabilities in the lung. The detection capabilities for eachreconstruction interval were 78, 83, 91 and 97%, respectively.The detection of nodules was superior for 12.5 and 10 mm imagesthan for 25 and 20 mm images (P<0.01). In 25 and 20 mm images,the detection capability was significantly lower in the apicalarea than in the middle area (P<0.01). For nodules 5 mm indiameter, 10 mm images permitted complete detection. HelicalCT fast couch speeds (20 or 25 mm/sec), which allow imagingof the entire lung during a single breath hold, may be usefulin detecting metastatic pulmonary nodules, and helical CT isexpected to be a useful method for lung screening.     

CT增强薄层扫描异形血管强化征对小肺癌诊断的价值

目的：探讨ＣＴ增强薄层扫描图像上显示的异形血管强化征对小肺癌诊断和鉴别诊断的临床价值。方法：用ＣＴ增强薄层扫描和常规ＣＴ增强扫描对比研究３７例直径＜３ｃｍ的小肺癌,并同期研究１８例需鉴别的肺炎性假瘤和肺结核球作对照,分析这３种病变的ＣＴ增强薄层扫描征象特点。结果：①ＣＴ增强薄层扫描能清晰显示小肺癌病灶内肿瘤血管的特征性表现一异形血管强化征,而常规ＣＴ扫描难以显示该征象;②肺炎性假瘤和肺结核球病灶内一般不出现该种病理血管征象。结论：异形血管强化征对小肺癌的诊断和鉴别诊断具有特殊意义。     

食管癌患者放疗前后血清sIL-2R 的研究

 目的　探讨食管癌患者放疗前后血清 s IL- 2 R的变化及临床意义。方法　用双抗体夹心 ELISA法检测了 50例食管癌患者放疗前后血清 s IL- 2 R水平。结果　食管癌患者放疗前血清s IL- 2 R水平显著高于正常人 (P<0 .0 0 1 ) ,且随病情进展而升高。放疗后血清 s IL- 2 R水平较放疗前显著降低 (P<0 .0 1 )。存活二年的患者放疗结束时 ,血清 s IL - 2 R<80 0 u/ml与 80 0 u/ml两组有明显差异 (P<0 .0 1 )。结论　食管癌患者血清 s IL- 2 R明显增高 ,并与肿瘤进展 ,预后密切相关 ,可为肿瘤治疗疗效和判断预后的一个重要指标。     

多层螺旋CT动态增强扫描结合血管造影对肾癌术前评估价值探讨

[目的]探讨多层螺旋CT增强扫描结合血管造影对肾癌术前评估的价值.[方法]回顾性分析临床手术病理证实为肾癌患者46例,所有患者均行多层螺旋CT,将CT征象与手术病理结果对照,比较CT各影像学征象及血管受累情况与手术病理证实结果间有无统计学差异.[结果]各CT影像学征象及血管受累情况与手术病理结果之间均无明显统计学差异(P>0.05).[结论]多层螺旋CT动态增强扫描结合血管造影能够准确判断肾癌累及周围组织及血管情况,具有较高的术前评估价值.