垂体腺瘤X-刀治疗的应用技术探讨

APPLIED TECHNIQUES IN X-KNIFE OF PITUITRY ADENOMAS.

目的:探讨垂体腺瘤X-刀治疗的应用技术,以提高治疗质量.方法:总结并剖析48例垂体腺瘤X-刀治疗中头环安置、CT定位、图像识别和结构勾画、治疗计划制作及治疗后处理等各个环节的技术应用情况.结果:CT2mm层厚扫描对结构的识别和勾画优于4mm层厚者,个别低密度微腺瘤者仍需参考冠/矢状位片;治疗床角度和机架转角的调整甚为重要,关系到剂量递减梯度和治疗体积的质量;靶点越少,越容易避免"热点"效应.结论:应坚持薄层CT扫描和图像定位技术的不断改进,尽各种可能增加腺瘤和视路的分辨率;深入、深入了解照射原理和技术,反复调试治疗计划和校验摆位准确性亦很重要.

Objective: To evaluate treatment techniques in X - Knife of pituitary adenomas and improve treatment quality. Methods: The techniques used in all steps inchuding frame fixation, CT targeting, imaging identification and delineation of anatomial structures, treatment planning and postradiosurgical management were reviewed and evaluated. Results: The quality of identification and delineation by 2mm slice thickness imaging was better than by 4mm slice thickness imaging. Unfrequently, some low - density microadenomas had to be carefully delineated refering to coronial/sagittal films. The adjustment of table angles and gantry angles is much important, as it could markedly influence the dose gradient and treatment volume. The less the number of isocenters, the more easily the 'hot point' effect could be prevented. Conclusions: The techniques appling CT scanning in thin sclices and imaging targeting should be improved constantly. The resolving power of adenomas and optic apparatus should be improved by every means. It is also important to understand the radiation principle and technique thoroughly, to adjust treatment plan repreatedly and to regulate positioning accuracy attentively.