Modifications based on computed tomographic imaging in planning the radiosurgical treatment of arteriovenous malformations.
Modifications based on computed tomographic imaging in planning the radiosurgical treatment of arteriovenous malformations.
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基于计算机断层扫描成像的修改计划动静脉畸形的放射外科治疗。
作者：
D. Blatt;William A. Friedman;F. Bova
在用放射外科治疗动静脉畸形的早期过程中，注意到通过立体定向血管造影确定的病灶等中心点和直径通常不同于通过立体定向增强计算机断层扫描（CT）确定的病灶等中心点和直径。为了评估病灶动脉造影和CT表现之间差异的来源，对81个连续病例的剂量测定（来自存储在光盘上的治疗记录）进行了审查。在44例病例中，等中心平均相差3.6 mm，准直器尺寸不同。CT显示病灶增大14个（平均2.6mm），缩小30个（平均4.0mm）。总体而言，75%的病例血管造影和CT病灶不同。血管造影病灶确定的误差来源包括重叠血管、骨性结构、细丝状小动脉和不规则形状。
Early in the course of treating arteriovenous malformations with radiosurgery, it was noted that the nidus isocenter and diameter, as identified by stereotactic angiography, often differed from that identified by stereotactic enhanced computed tomography (CT). To assess the sources of discrepancy between the arteriographic and CT representations of the nidus, dosimetry (from treatment records stored on an optical disk) was reviewed in 81 consecutive cases. In 44 cases, the isocenters differed by an average of 3.6 mm and the collimator size differed. Fourteen nidi were larger on CT (average, 2.6 mm), and 30 were smaller on CT (average, 4.0 mm). Overall, the angiographic and the CT nidus differed in 75% of the cases reviewed. Sources of error in the angiographic nidus determination included overlapping vessels, bony structures, fine filamentous arterioles, and irregular shapes.