摘要
目的 探究MRI、CT结合3D打印技术在治疗妇科疾病中的临床应用价值。方法 选取2022年1月-12月期间新疆维吾尔自治区人民医院收治的48例宫颈癌患者,分别采用3D打印方法进行插植针插入治疗的CT平扫(研究组)24例及徒手IC-ISBT CT(对照组)24例。应用3.0T MRI进行平扫+增强检查,从DICOM文件中提取患者的MRI增强图像,并使用3D-DOCTOR医学成像算法平台和3D-DOCTOR医学成像数据处理平台对数据进行后期处理,使用热塑性塑料进行3D打印重塑出3D模型。采用3D型指导医务人员在CT引导下进行宫颈癌三维腔内近距离放射治疗;于Nucletron Oncentra计划系统中设计相应的插植针道及针数、驻留点及驻留时间,逆向优化后形成预计划;分别评估研究组和对照组靶区、危及器官的剂量学参数的差异。观察宫颈癌放疗的近期疗效及毒副作用。结果 对使用3D打印的个体化阴道模板治疗的48例患者分别进行了CT扫描和徒手IC-ISBT CT平扫,结果显示,2组的插入位置相似,差异无统计学意义(P> 0.05);研究组的IR-CTV D90、IR-CTV D100、HR-CTV D100与对照组对比,差异无统计学意义(P> 0.05);研究组的HR-CTV D90与对照组相比,差异有统计学意义(P <0.05);研究组的膀胱、直肠、乙状结肠D5cc、D2cc、D1cc、D0.1cc与对照组对比,差异无统计学意义(P> 0.05);48例患者中,40例患者复查肿瘤均消失达到完全缓解,8例达到部分缓解,有效率为83.33%;没有2度以上毒副作用。结论 MRI、CT结合3D打印技术在治疗妇科疾病中的应用效果较好,3D打印模型能很好地显示肿瘤的大小、位置以及与周围正常组织的关系,并能有效地支持医生对宫颈癌进行个性化的近距离治疗。
Objective To explore the clinical application value of magnetic resonance imaging(MRI),computed tomography(CT)combined with three-dimensional(3D)printing technology in the treatment of gynecological diseases.Methods 48 cervical cancer patients admitted to the People’s Hospital of Xinjiang Autonomous Region from January 2022 to December 2022 were selected and divided into the control group and the study group,with 40 patients in each group.The study group performed CT plain scan for needle insertion therapy using 3D printing method,while the control group used freehand IC-ISBT CT.The 3.0T MRI was used for plain scanning+enhanced examination,the patient’s MRI enhanced images were extracted from DICOM files,the the 3D-DOCTOR medical imaging algorithm platform and the 3D-DOCTOR medical imaging data processing platform were used for postprocessing of the data, and thermoplastic plastics were used for 3D printing to reconstruct the 3D model. Under the guidance of 3D, medical personnel performed 3D intracavitary brachytherapy for cervical cancer under CT guidance;The corresponding insertion needle path, number of needles, dwell point, and dwell time were designed in the Nucletron Oncenter planning system, and a pre plan was formed after reverse optimization. The differences in dosimetric parameters of the target volume and organs at risk between the study group and the control group were evaluated. The short-term efficacy and toxic side effects of radiotherapy for cervical cancer were observed. Results CT scans and freehand IC-ISBT CT plain scans were performed on 48 patients treated with individualized vaginal template therapy using 3D printing. The results showed that the insertion positions of the two groups were similar and there were no statistically significant differences (P >0.05). There were no statistically significant differences in the lowest dose level accepted at 90% volume of intermediate risk-clinical target volume (IR-CTV D90), IR-CTV D100, and the lowest dose level accepted at 100% volume of high r
作者
米艾赛·吐尔逊
帕丽旦·尼亚孜
陈杰
尼鲁帕尔·艾比布拉
王姗姗
MIAISAI•Tuerxun;PALIDAN·Niyazi;CHEN Jie;NILUPAER·Aibibula;WANG Shanshan(Radiographic Imaging Center,the People’s Hospital of Xinjiang Autonomous Region,Urumqi 830001,China)
出处
《长春中医药大学学报》
2023年第9期1034-1038,共5页
Journal of Changchun University of Chinese Medicine
基金
新疆维吾尔自治区自然科学基金项目(2018D01C136)。
关键词
妇科疾病
3D打印
宫颈癌
MRI
CT
gynecological diseases
three-dindensional printing
cervical cancer
magnetic resonance imaging
computed tomography
