摘要
目的对原发性肝癌适形放疗后的患者进行CT、MR平扫或增强扫描,以发现其特征,为与适形放疗后病灶未控或复发提供鉴别依据。方法33例单发肝癌患者采用适形放疗,3648Gy/812次,隔日1次。13个月后开始CT、MRI复查。对TDF值≥90及<90时与CT影像学异常,关系进行四格表精确检验法统计学处理。结果15例次CT平扫表现为低密度。增强扫描无强化,6例次;动脉期为低密度,门脉期或延迟期呈强化状态,2例次;早期至延迟期均强化,2例次。5例次MRI平扫T1加权呈低或等信号,4例次T2加权呈等信号,1例呈略高信号。5例增强扫描出现进行性强化。TDF值≥90与<90的放射剂量导致的CT影像学异常,差异具有显著性(P=0.003)。结论照射后,高剂量照射区的肝脏CT可表现为低密度,MRIT1加权表现为低或等信号;可以出现强化,特征为进行性或持续性强化。当TDF值≥90时,容易出现CT影像学异常。
Objective To study the appearance of radiation-induced liver injury in CT and MRI after conformal radiation therapy. Methods Thirty-three patients with single localized liver tumor were treated with conformal radiation therapy at a total dose of 36-48Gy for 8-12 times. 1-3 months later,CT scan and/or MR imaging were performed. Results Low density appeared in 15 CT studies. The type Ⅰ appearance with no enhancement in high dose region existed in 6 studies, type Ⅱ with low density in artery phase and high density in portal vein phase or prolonged phase existed in 2 studies, and type Ⅲ with persistent high density from artery phase to prolonged phase in 2 studies. In T1 weighted MR imaging,low or iso-signal appeared in 5 studies. In T2 weighted imaging, iso-signal appeared in 4 studies and slightly high signal appeared in 1 patient. In contrast enhancement imaging,the signal became higher and higher in 5 patients. Radiation dose of TDF ≥90 more readily led to abnormal liver image than TDF 〈 90 did in CT scan statistically （P = 0.003 ）. Conclusion After conformal radiation therapy,low density or isedensity exists in CT scan,low or iso-signal in T1 weighted imaging, and isosignal or slightly high signal in T2 weighted MR imaging. If high density or sig- nal is observed in contrast enhancement imaging, a kind of gradual intensification pattern should appear. When TDF 990, abnormal CT image would appear.
出处
《中国肿瘤临床与康复》
2006年第6期516-518,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
肝肿瘤/放射疗法
放射性肝损伤
CT
MRI
Liver neoplasms
/radiotherapy
Radiation-induced liver injury
CT
MR imaging
