胸部MRI精确勾画靶区对肺癌治疗的价值分析

Treatment values of precise target delineation of chest MRI for lung cancer

目的:探讨胸部MRI精确勾画靶区对于治疗肺癌的价值。方法:选取2011年8月至2015年2月在我院诊治的45例非小细胞肺癌患者,在放疗前选择胸部CT扫描和MRI扫描,积极进行肿瘤靶区的勾画,并对影响因素进行分析。结果:所有患者都完成CT与MRI的扫描定位,CT难以鉴别肺癌造成的气肺组织病变,MRI成像显示肿瘤部分均呈高信号,肿瘤与周围正常组织的界限变得比较清晰。同时CT确诊为边界区分20例,而MRI确诊为边界区分25例;CT确诊为淋巴结转移36例,MRI确诊为淋巴结转移40例,为此CT与MRI肿瘤靶区的边界区分与淋巴结转移诊断对比差异都有统计学意义(P<0.05)。单因素Logistic回归分析结果显示病理类型和肺不张是CT与MRI肿瘤靶区勾画差异的影响因素(P<0.05),而多因素Logistic回归分析结果显示肺不张为主要的影响因素(P<0.05)。结论:相对于CT,肺癌放疗过程中胸部MRI精确勾画靶区能提高靶区定位的精确性,有利于判断淋巴结转移情况,避免肺不张的影响,确保放疗的精确性。

Objective To investigate the treatment values of precise target delineation of chest MRI for lung cancer Methods From August 2011 to February 2015, 45 non-small cell lung cancer patients were given chest CT scans and MRI scans before radiotherapy, and then active target tumor delineation, then related influencing factors were analyzed. Results All patients completed CT scans and MRI positioning. For patients that it was difficult to identify lung tissue lesions caused by lung cancer through CT, their MRI imaging showed high signal and the boundaries between the tumor and surrounding normal tissue became relatively clear. Meanwhile, 20 patients of borders were diagnosed by CT, while 25 by MRI; 36 patients with lymph node metastasis were diagnosed by CT while 40 by MRI. The difference was statistically significant （P〈0.05）. Univariate logistic regression analysis showed that pathological type and atelectasis were the influence factors for CT and MRI tumor target delineation differences （P〈0.05）, and multivariate logistic regression analysis showed the atelectasis was the main factor （P〈0.05）. Conclusion Compared with CT, breast MRI can precisely delineate target to improve the accuracy of target localization before radiotherapy. It can help determine lymph node metastasis and avoid the impact of atelectasis then ensure the accuracy of radiotherapy.