应用4DCT观察呼吸运动中肺部肿瘤位移和体积变化

王少锋

【摘要】 目的：探討应用4DCT观察呼吸运动中肺部肿瘤位移和体积变化。方法：选取肺部肿瘤患者30例，应用4DCT对各时相GTV变化及大体肿瘤最大延伸范围进行分析，并对大体肿瘤、脊髓几何中心及体表标记点的三维运动矢量进行观察。结果：相较于T0时相，T1、T2、T3及T9时相平均GTV增加为（9±3）%，T4、T5、T6、T7、T8时相平均GTV减少为（16±5）%。GTV<15 cm3的体积变化为（26±5）%，GTV≥15 cm3的体积变化为（15±6）%，差异有统计学意义（P=0.000）。大体肿瘤的位置对体积变化无明显影响，大体肿瘤位于上肺的体积变化为（12±5）%，大体肿瘤位于下肺的体积变化为（14±6）%，差异无统计学意义（P=0.166）。大体肿瘤位于中心的体积变化为（15±3）%，大体肿瘤位于周围的体积变化为（17±5）%，差异无统计学意义（P=0.065）。大体肿瘤X、Y、Z方向的最大延伸范围比较，差异无统计学意义（P>0.05）。大体肿瘤几何中心三维运动矢量为（8.0±2.0）mm，脊髓几何中心三维运动矢量为（0.9±0.4）mm，身体前部标记点三维运动矢量为（2.0±0.9）mm，右侧标记点三维运动矢量为（1.9±0.8）mm，左侧标记点三维运动矢量为（1.6±0.6）mm。结论：4DCT可有效观察呼吸运动中肺部肿瘤位移和体积变化。

【关键词】 4DCT 肺部肿瘤 位移 体积变化

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