Definition of the margin of major coronary artery bifurcations during radiotherapy with electrocardiograph-gated 4D-CT
Definition of the margin of major coronary artery bifurcations during radiotherapy with electrocardiograph-gated 4D-CT
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DOI：
10.1016/j.ejmp.2018.05.008
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发表时间：
2018-05-01
影响因子：
3.4
通讯作者：
Gong, Guanzhong
中科院分区：
文献类型：
--
作者：
Li, Qian;Tong, Ying;Gong, Guanzhong
目的：目的是测量心脏运动引起的位移的主要冠状动脉分叉利用心电图（ECG）门控四维计算机断层扫描（4D-CT），并确定边缘的冠状动脉bifurcations.Methods：37例女性患者进行回顾性心电门控4D-CT吸气屏气（IBH）。绘制了左冠状动脉主干分叉（LM）、钝缘分支分叉（OM）、第一对角分支分叉（D-1）、第二对角分支分叉（D-2）、左前降支分支尾侧部分（APX）、第一右心室动脉分叉（V）和急性缘分支分叉（AM）的轮廓。结果：冠状动脉分支在左-右（LR）、颅-尾（CC）、前后（AP）坐标系下的边缘分别为：LM 3、3、3 mm，D-1 6、3、3 mm，D-2 3、3、3 mm，D-3 3、3 mm，D-3 3、3 mm，D-2 3、3 mm，D-3、3 mm，D-3 APX 4、4、4 mm; OM 4、6、5 mm; V 6、8、7 mm; AM 6、8、7 mm。结论：冠状动脉分叉应被视为一个独立的危险器官（OAR），由于运动位移的不同，应提供不同的边缘。左冠状动脉分叉的LR、CC和AP坐标中的最大边缘分别为6、6和5 mm，右冠状动脉分叉的最大边缘分别为6、8和7 mm。
Purpose: The aim was to measure the cardiac motion-induced displacements of major coronary artery bifurcations utilizing electrocardiography (ECG)-gated four-dimensional computed tomography (4D-CT) and to determine the margin of coronary artery bifurcations.Methods: Thirty-seven female patients who underwent retrospective ECG-gated 4D-CT in inspiratory breath hold (IBH) were enrolled. The left main coronary artery bifurcation (LM), the obtuse marginal branch bifurcation (OM), the first diagonal branch bifurcation (D-1),the second diagonal branch bifurcation (D-2), the caudal portion of the left anterior descending branch (APX), the first right ventricular artery bifurcation (V) and the acute marginal branch bifurcation (AM) were contoured. The center of the contour of the coronary arterial bifurcations at end systole was defined as the standard, and the margin were then calculated.Results: The margin in the left-right (LR), cranio-caudal (CC), and anterior-posterior (AP) coordinates were as follows: LM 3, 3, and 3 mm; D-1 6, 3, and 3 mm; D-2 3, 3, and 3 mm; APX 4, 4, and 4 mm; OM 4,6, and 5 mm; V 6, 8, and 7 mm; and AM 6, 8, and 7 mm, respectively.Conclusion: Coronary artery bifurcations should be considered a separate organ at risk (OAR), and different margin should be provided due to the differences resulting from motion displacement. The maximum margin in the LR, CC, and AP coordinates of left coronary artery bifurcations were 6, 6, and 5 mm, and those of the right coronary artery bifurcations were 6, 8, and 7 mm, respectively.