氢质子磁共振波谱检测脑胶质瘤放疗后的放射性脑损伤

J4 ›› 2011, Vol. 37 ›› Issue (4): 742-745.

氢质子磁共振波谱检测脑胶质瘤放疗后的放射性脑损伤

张矛|金海国|孙树全|卜明伟|苏清秀|刘贵刚|孙宝胜

吉林省肿瘤医院放疗三科|吉林长春 130012

收稿日期:2011-04-24 出版日期:2011-07-28 发布日期:2011-07-28
通讯作者: 张矛(Tel：0431-85877258，E-mail：zm19621127@sina.com) E-mail:zm19621127@sina.com
作者简介:张矛（1962-）|男|吉林省长春市人|主任医师|主要从事肿瘤放射治疗学的研究。
基金资助:
吉林省自然科学基金资助课题（201015235）

Detection of |radiation brain injury of malignant glioma by 1H-MRS

ZHANG Mao,JIN Hai-guo,SUN Shu-quan,BU Ming-wei,SU Qing-xiu,LIU Gui-gang,SUN Bao-sheng

Third Department of Radiation Oncology,Tumor |Hospital, Jilin Province,Changchun 130012,China

Received:2011-04-24 Online:2011-07-28 Published:2011-07-28

摘要/Abstract

摘要：

目的：利用氢质子磁共振波谱(1H-MRS)方法，探讨容积旋转调强（VMAT）技术与三维适形放射治疗（3DCRT）技术对脑胶质瘤术后患者行放射治疗后放射性脑损伤的差别。方法：24例经临床手术证实的恶性胶质瘤（WHOⅡ～Ⅳ级胶质瘤）术后患者，其中12例进行VMAT技术放疗，另外12例进行3DCRT技术放疗，处方剂量全部为DT60-66GY/30-33F，比较2组计划的剂量分布图，并运用1H-MRS检查2组放疗前后感兴趣区(ROI)脑组织中N-乙酰天门冬氨酸（NAA）、肌酸（Cr）、胆碱（Cho）的代谢规律，计算NAA/Cr、Cho/Cr、NAA/Cho比值，比较各组数据。结果：VMAT组剂量分布明显优于3DCRT组，放疗后2组患者NAA/Cr比值较放疗前有所降低，2组治疗后NAA/Cr比值比较差异有统计学意义（P<0.01）；放疗后2组患者Cho/Cr、NAA/Cho比值较放疗前有所增高，2组治疗后NAA/Cho比值比较差异有统计学意义（P<0.01）。结论：利用VMAT技术对脑胶质瘤术后患者进行放疗，较利用3DCTR技术放疗在减轻放射性脑损伤方面有一定优势。

关键词: 容积旋转调强；三维适形放射治疗；氢质子磁共振波谱；脑胶质瘤

Abstract:

Abstract:Objective Using proton magnetic resonance spectroscopy (1H-MRS) method ，to evaluate the difference of radiation brain injury between volumetric modulated arc therapy (VMAT) and three-dimensional conformal radiation therapy (3DCRT) in patients with postoperative glioma after radiation therapy.Methods 24 patients with malignant glioma (WHOⅡ-Ⅳ grade glioma) confirmed with clinical surgery were selected,among them 12 patients were treated with VMAT technique,and another 12 patients with 3DCRT technique,all received DT60-66GY/30-33F dose prescriptions. 1H-MRS examination was performed to analyze the change of metabolites in the brain tissues of region of interest (ROI) before and after radiotherapy,and the ratios of NAA/ Cr,Cho / Cr,NAA / Cho were computed.Results The dose distribution of VMAT group was superior to 3DCRT group,the NAA/Cr in two groups after radiation were decreased compared with before radiation,there was a statistically difference in NAA/Cr after radiation between two groups (P<0.01).The Cho / Cr and NAA / Cho in two groups were increased compared with before radiation;after radiation,only NAA/Cho had a statistical difference between two groups (P<0.01).Conclusion VMAT technique is superior to 3DCTR to reduce radiation brain injury in patients with postoperative glioma.

Key words: volumetric modulated arc therapy, three-dimensional conformal radiation therapy;magnetic resonance spectroscopy, malignant glioma

中图分类号:

R739.41

张矛|金海国|孙树全|卜明伟|苏清秀|刘贵刚|孙宝胜 . 氢质子磁共振波谱检测脑胶质瘤放疗后的放射性脑损伤[J]. J4, 2011, 37(4): 742-745.

ZHANG Mao,JIN Hai-guo,SUN Shu-quan,BU Ming-wei,SU Qing-xiu,LIU Gui-gang,SUN Bao-. Detection of |radiation brain injury of malignant glioma by 1H-MRS[J]. J4, 2011, 37(4): 742-745.