應用4DCT觀察呼吸運動中肺部腫瘤位移和體積變化

王少鋒

【摘要】 目的：探討應用4DCT觀察呼吸運動中肺部腫瘤位移和體積變化。方法：選取肺部腫瘤患者30例，應用4DCT對各時相GTV變化及大體腫瘤最大延伸范圍進行分析，并對大體腫瘤、脊髓幾何中心及體表標記點的三維運動矢量進行觀察。結果：相較于T0時相，T1、T2、T3及T9時相平均GTV增加為（9±3）%，T4、T5、T6、T7、T8時相平均GTV減少為（16±5）%。GTV<15 cm3的體積變化為（26±5）%，GTV≥15 cm3的體積變化為（15±6）%，差異有統計學意義（P=0.000）。大體腫瘤的位置對體積變化無明顯影響，大體腫瘤位于上肺的體積變化為（12±5）%，大體腫瘤位于下肺的體積變化為（14±6）%，差異無統計學意義（P=0.166）。大體腫瘤位于中心的體積變化為（15±3）%，大體腫瘤位于周圍的體積變化為（17±5）%，差異無統計學意義（P=0.065）。大體腫瘤X、Y、Z方向的最大延伸范圍比較，差異無統計學意義（P>0.05）。大體腫瘤幾何中心三維運動矢量為（8.0±2.0）mm，脊髓幾何中心三維運動矢量為（0.9±0.4）mm，身體前部標記點三維運動矢量為（2.0±0.9）mm，右側標記點三維運動矢量為（1.9±0.8）mm，左側標記點三維運動矢量為（1.6±0.6）mm。結論：4DCT可有效觀察呼吸運動中肺部腫瘤位移和體積變化。

【關鍵詞】 4DCT 肺部腫瘤 位移 體積變化

patients with lung tumors were enrolled， and 4DCT was applied to analyze the changes of GTV in various phases and the maximum extension range of gross tumor， and to observe three-dimensional motion vector in the geometric center of gross tumor and spinal cord and the marker points on body surface. Result： T1， T2， T3 and T9 phase average GTV increased to （9±3）% and T4， T5， T6， T7， T8 phase average GTV decreased to （16±5）% compared with the T0 phase. The volume change of GTV<15 cm3 was （26±5）%， and the volume change of GTV≥15 cm3 was （15±6）%， and the differences were statistically significant （P=0.000）. The location of the gross tumor had no significant effect on the volume change， and the volume change of gross tumor in the upper lung was （12±5）%， and the volume change of gross tumor in the lower lung was （14±6）%， and the difference was not statistically significant （P=0.166）. The volume change of the gross tumor was （15±3）%， and the change of the surrounding volume was （17±5）%， and the difference was not statistically significant （P=0.065）. The maximum extents of gross tumors in X， Y， and Z directions were compared， and the differences were not statistically significant （P>0.05）. The three-dimensional motion vector in the geometric center of gross tumor was （8.0±2.0） mm， the three-dimensional motion vector in the geometric center of spinal cord was （0.9±0.4） mm， the three-dimensional motion vector in the front of the body was （2.0±0.9） mm，

the three-dimensional motion vector in the right marker was （1.9±0.8） mm， and the three-dimensional motion vector in the left marker was （1.6±0.6） mm. Conclusion： 4DCT can effectively observe the displacement and volume changes of lung tumors in respiratory movement.

[Key words] 4DCT Lung tumor Displacement Volume change

First-authors address： The Second Affiliated Hospital of Xiamen Medical College， Xiamen 361021， China