Development of Prediction of Radiation Pneumonitis by Phase-Contrast Cine MR Sequence

本文对1999年以来连续3年接受放射治疗的18例原发性肺癌和22例原发性食管癌患者进行了详细的研究，并在治疗前进行了肺动脉时间-速度曲线的电影MRA。5例肺癌发生2级以上放射性肺炎（RP），2例2级，2例3级，1例4级; 4例食管癌发生RP，2例2级，1例3级，1例4级。假设肺血管阻力是一个高的条件，因为他们的肺部疾病的背景，如肺纤维化，因此，我们研究了以下。对40例患者在治疗开始前用数字化仪分别对左、右肺动脉进行电影磁共振血管成像（cineMRA），分析其时间-速度曲线。和从心脏收缩开始的峰值（峰值）处的面积 ...更多信息 区域面积）、峰值速度、从收缩开始的停车时间（峰值时间）、收缩时的最大加速度、到峰值的半值宽度和最大加速度/峰值区域面积。比较RP组和非RP组的这些值。本研究纳入了肺癌病例中照射的单侧肺和食管癌病例中照射的双侧肺。试验采用等分粉末t检验，结果重新分析峰面积、峰时间、半峰宽、最大加速度/峰面积的显著性，最显著的因素是峰时间，其值小于0.001。以RP组峰值时间平均值111 ms为界值，敏感性、特异性、总预测值分别为58%、88%、83%。相位对比电影MRA肺动脉时间-速度曲线中的各种因素对放射性肺炎的预测有一定的参考价值。特别地，峰值时间（即，从收缩阶段开始直到流速达到峰值的时间）的有用性高，因为其可以在不使用数字转换器的情况下方便地测量。少

The detailed investigation was carried out on 18 cases of primary lung and 22 cases of primary esophageal cancer who underwentradiotherapy treatment in the study duration for 3 years from the 1999 fiscal year and cine MRA depicting the pulmonary arterial time-velocity curve before therapy. Radiation pneumonitis (RP) of grade 2 or more occurred in 5 cases of lung cancer including 2 cases of grade 2, 2 of grade 3, and 1 of grade 4, RP occurred in 4 cases of esophageal cancer including 2 cases of grade2, 1 of grade 3, and 1 of grade 4.The cases, which cause the RP, are assumed that the pulmonary vascular resistance is a high condition because of their background of pulmonary diseases such as pulmonary fibrosis, therefore, we examined the following. Time-velocity curve obtained by cine MRA of the right and left pulmonary artery respectively was analyzed before the treatment start on total of the 40 cases using the digitizer. And area at the peak from the cardiac contraction start (the peak … More region area), peak velocity, time at the park from the contraction start (peak time), maximum acceleration at contraction, half-value width to the peak, and maximum acceleration/peak region area were measured. These values were compared between the RP and non-RP groups. Irradiated unilateral lung in the lung cancer cases and irradiated bilateral lung in esophageal cancer cases were entered in this study. Equal dividing powder t-test was used in the test.The result recoanizes the significance at peak region area, peak time, half-value width to the peak, maximum acceleration/peak region area, and the most significant factor was peak time showing less than 0.001 value. In making mean value 111ms of the peak time of the RP group to be the cut off value, sensitivity, specificity, overall predictive value were 58 % 88 % and 83 % respectively. Various factors obtained from pulmonary arterial time-velocity curve from phase-contrast cine MRA are useful in predicting radiation pneumonitis. Especially, usefulness of the peak time I.e. the time until flow velocity reaches the peak from the contraction stage start is high, because it can be conveniently measured without usage of a digitizer. Less