- 期刊
利用術中電腦斷層導航系統與核磁共振影像對位融合技術製作經皮穿刺三叉神經疼痛治療計畫暨影像、劑量評估
The Dose and Image Evaluation of Using Intraoperative CT and MRI Image Registration/Fusion Technology to Treated Percutaneous Radiofrequency Trigeminal Rhizotomy
摘要
三叉神經痛為一常見之臉部疼痛，本研究將以術中電腦斷層導航系統融合MRI 影像技術進行三叉神經射頻燒灼術（percutaneous radiofrequency trigeminal rhizotomy, RF-TR）治療計畫製作及手術。術中電腦斷層導航系統（intraoperative computed tomography, i-CT）為一精準的影像導引手段可用來導引針頭進入三叉神經節進行治療，影像對位融合是一種將不同特性儀器所產生的斷層影像結合之技術。本研究將比較僅利用術中電腦斷導航系統與利用CT/MRI對位融合導航系統手術後導引針頭與三叉神經節距離來進行影像之評估，並計算病患掃描次數以及有效劑量差異。針尖至三叉神經節距離CT組為4.2±1.3 mm，CT/MRI組為0.6±1.3 mm（p＜0.005）；電腦斷層掃描次數，CT組為4.1±2.5次，CT/MRI組為2.9±1.1次（p＜0.05）；CT組與CT/MRI組之劑量差異其結果CT組為7.8±2.8 mSv，CT/MRI組為2.3±1.1 mSv（p＜0.005）。研究結果顯示利用CT/MRI影像對位融合來製作RF-TR治療計畫並配合導航系統來執行手術，實驗結果皆顯著地優於CT組之病患。
並列摘要
Trigeminal neuralgia is a common cause of facial pain clinically, in this study, the percutaneous radiofrequency trigeminal rhizotomy (RF-TR) treatment plan and procedure was executed by intraoperative CT image fusion with MRI technology. The needle was inserted into the trigeminal ganglion with high precision guided by intraoperative CT and navigation. Image registration and fusion was an images combined technology from different imaging modalities. In this study, needle to trigeminal ganglion distance, patient absorbed dose and scan times were measured and evaluated for the CT and CT/MRI groups. The needle to trigeminal ganglion distance was 4.2±1.3 mm in the CT group, and 0.6±1.3 min in the CT/MRI group (p＜0.005); the CT scan time was 4.1±2.5 in the CT group and 2.9±1.1 in the CT/MRI group (p＜0.05); the patient absorbed radiation dose was 7.8±2.8 mSv in the CT group, and 2.3±1.1 mSv in the CT/MRI group (p＜0.005). The results showed the use of CT/MRI fusion technology for the treatment plan and image-guided procedure was significant improved with respect to precision and patient absorbed radiation dose when compared to the CT group.
延伸閱讀
- 廖書柏、許筑翔、葉美妤、陳文昌、吳萬福、王裕生（2017）。低劑量術中電腦斷層導航系統暨磁振造影融合執行經皮三叉神經射頻燒灼術。中華放射線技術學雜誌，41(1)，34-40。https://www.airitilibrary.com/Article/Detail?DocID=16849418-201703-201705030009-201705030009-34-40
- 陳文昌、王士崇、林秋湧、陳志峰（2014）。顯影劑前後磁共振三維短時間反轉恢復序列最大強度投影對臂神經叢之研究。中華放射線技術學雜誌，38(4)，205-212。https://www.airitilibrary.com/Article/Detail?DocID=16849418-201412-201501290033-201501290033-205-212
- 郭晟恩（2019）。應用於磁振造影導引聚焦式超音波腦腫瘤治療之三維定位系統〔碩士論文，國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342/NTU201902295
- Ting, W. C., Yang, C. C., Chang, C. H., Chen, T. Y., Wu, T. C., Ho, H. W., & Lin, L. C. (2017). 電腦刀放射線手術用於難治型三叉神經痛：單一機構經驗. 放射治療與腫瘤學, 24(3), 175-185. https://doi.org/10.6316/TRO/201724(3)175
- Chang, Y. M., & Wei, F. C. (2018). Two-Stage Functional Rehabilitation with Free Flap and Dental Implantation in Oral Cancer Patients Receiving Extensive Maxillectomy and Postoperative Radiotherapy-A Case Report. 臺灣口腔顎面外科學會雜誌, 29(2), 88-95. https://www.airitilibrary.com/Article/Detail?DocID=a0000494-201806-201807310018-201807310018-88-95