Wechsler R J, Ayyangar K, Steiner R M, Yelovich R, Moylan D M
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107.
Comput Med Imaging Graph. 1990 Jan-Feb;14(1):43-51. doi: 10.1016/0895-6111(90)90139-3.
High doses of external beam radiotherapy are required to obtain local control of many intrathoracic neoplasms. Because spinal cord tolerance limits the radiation dose that can be given through anterior and posterior fields, it is often necessary to increase the dose to the primary tumor site using oblique or lateral fields. When pulmonary infiltrates develop following treatment in these patients, it is frequently difficult to distinguish between infection, recurrent tumor, and radiation pneumonitis. In nine patients in whom acute pulmonary infiltrates occurred following a course of thoracic irradiation, computed tomography (CT) with computed dosimetric reconstruction (CDR) were studied in an attempt to correlate the treatment volumes with the location and configuration of the infiltrates and in this way establish the source for the pulmonary abnormalities. In seven of these patients, the diagnosis was changed, and the resulting post-irradiation clinical therapy was altered as a consequence of this retrospective study.
为实现对许多胸内肿瘤的局部控制，需要高剂量的外照射放疗。由于脊髓耐受性限制了通过前后野给予的辐射剂量，因此常常需要使用斜野或侧野来增加原发肿瘤部位的剂量。当这些患者在治疗后出现肺部浸润时，往往很难区分感染、肿瘤复发和放射性肺炎。对9例在进行胸部照射后出现急性肺部浸润的患者，研究了采用计算机剂量重建（CDR）的计算机断层扫描（CT），试图将治疗体积与浸润的位置和形态相关联，从而确定肺部异常的来源。在其中7例患者中，由于这项回顾性研究，诊断发生了改变，放疗后的临床治疗也因此而改变。
