肺原发性黏液腺癌是肺腺癌的罕见临床亚型，据报道仅占肺腺癌的0．14％［1］。目前的研究多以病例报道的形式对其进行分析，而系统地从影像学角度的分析报道并不多见，本次研究主要回顾性分析大连医科大学附属第一临床医院2006年3月至2012年12月期间经病理证实的10例肺黏液腺癌CT 征象，并结合文献情况总结其 CT 影像特征，旨在提高对此型肺癌影像诊断的准确性和全面认识。

由于三维放疗方法的日益普及,多叶准直器(muhi-leaf collimator,MLC)的使用越来越多.笔者在实际工作中遇到1例连线方面故障,现介绍如下.一、故障现象在维修机器其他故障时,对MLC的B面电路板进行了拆卸,复位后对MLC进行自检.开始时所有的叶片都回到了零位,只有B31叶片没用收回,工作站电脑提示Carriage已运动到极限位置,自检中断停止.用Service panel单独操作B31,进退都无反应.将B31电机拆下,保持接线正常连接,仍用Service panel操作,发现电机不转。

[Objective] To present a more effective way to determinate the target volume in electron beam irradiation while using three-dimensional treatment planning system.[Methods] Contoured the target volume according to the images from CT simulation,and designed the electron beam irradiation field by using 3DTPS.Calculated the shifting coordinate of irradiation field based on the original coordinate.Installed the applicator with the leaden block of electron beam onto the accelerator.Turned on the lamp field and marked the cross line on the plate.A foam mould which was marked with filed centre and direction should be cutted based on the DR image from TPS.The leaden block would be made on a premise that the cross lines on the plate and the foam were coincident.Evaluated the feasibility of this method by radiotherapy verification.[Results] The offset degree of target centre was less than 2.2 mm,also the maximum deviation is less than 1.7 mm.[Conclusion] The method that coincide the irradiation field centre and the centre from TPS can solve the problem of target area's variation.Also the method can ensure the process of electron irradiation going smoothly.

Objective To discuss about moulding leaden block in posterior neck electron beam irradiation for the radiotherapy of nasopharyngeal carcinoma.Methods Five nasopharyngeal carcinoma patients with different depth of isocenter points were selected in this research.We sketched the posterior neck electron beam irradiation field on the facial mask according to lamplight projection,and calculated the corrected source to film distance by geometry method based on given source to film distance.The leaden blocks were made respectively according to the practical and corrected source to film.Then the patients were moved to the accelerator and localized for radiotherapy.We evaluated the conformance of the radiation fields from both practical and corrected source to film distance while each compared to the original surface mark.Results The corrected source to film distance of each patient is bigger than practical source to film distance.And the field based on practical source to film distance leaded relatively large deviation,which can reach 1.25 cm on maximum.After corrected,the deviation can be narrow down to 0.22 cm.Conclusion Moulding leaden block for posterior neck irradiation based on original image with isocenter point would lead to a relatively large deviation.The leaden block field and the surface mark would fit better by correcting the source to film distance.

患者,男性,56岁.2010年5月初无明显诱因出现间歇性头痛,6月3日凌晨4时患者头痛加重伴左侧手指麻木,随后出现四肢抽搐及意识障碍,并不慎跌倒,擦伤右额部,昏迷时间持续5 min,清醒后对当时情况记忆不清.头颅CT示:右侧颞顶枕叶交界区低密度影,边界欠清晰,横径约3.2 cm,局部混杂密度,右侧脑室后角略受压,中线无偏移.

Purpose:Research about the method and clinical application of postural fixation adding on the broad of simulated positioner.Method:Using formed hot press molding to sampling on the broad of accelerator provided with fixture.As the way mentioned above to sample on the simulated positioner.Mark the relevant position of broad,and adding the fixture.Results:Observing 270 patients with first accelerated therapy.Conclusion:Comparing there graticule,we can get that this method(introduced in this paper) can make the mistake within 2mm.So,it is worth to promote in the hospital with same level.

因X线肉眼无法看到,实际操作过程中用可见光野去摸拟实际照射野,因此治疗位置精确度取决于光野、照射野的一致性.为避免超差,必须定期检测.

> 放疗的基本目标是使肿瘤区域被精确地定位,然后有足够精确的治疗剂量,并使周围正常组织和器官受照射最少,因此治疗设备的机械及剂量精度是这一目标实现的前提。一、材料与方法故障现象:瓦里安23Ex加速器铅门X 1 在月检中发现读数已严重超差,开到20 cm时,读数为19 cm,其他铅门读数正常。二、结果1.检测:首先进入服务模式,反复几次校准铅门X 1 ,偏

> 笔者在日常工作中发现1例瓦里安 Clinac 23EX 直线加速器 STPS 联锁事故,经检修得以修复,经验供大家参考。一、材料与方法机器在没有出束的情况下,突然出现 STPS 联锁,机架、床无法运动。在维修模式下,按下床控器的 Enable 和 VRT

Introduce the development method of an utility type irradiational measure board, and apply it to the work of radiotherapy irradiation,thereby get a ture diagraph data of body position error margin, effectively improve the accuracy of body position in the radiotherapy.It is an effective way to strenghthen the radiotherapy quality management and quality control.

故障现象 在没有安装托架和限光筒的情况下,旋转机架,准直器上的Reset按钮红灯被点亮,使机架旋转、床升降等运动被锁住,按Reset按钮不能恢复,若一直按住Reset按钮不放,能够恢复各运动.

目的: 探讨放射治疗网络的构建方法和意义.方法: 将各种仪器设备按用途分成三个子网,各子网分别与网络服务器相连,组成一个星形网络拓扑结构的放疗局域网络系统.结果: 对接受治疗的560例患者进行从病例录入、定位、计划设计和治疗实施的网络化管理,未出现超剂量和错误治疗.结论: 放疗网络的构建使各设备之间完全实现了信息共享,不仅提高了工作效率,而且大大增加了治疗的精确性,是放射治疗临床质量保证和质量控制的有效工具.

目的回顾性分析脑胶质瘤患者术后放射治疗及综合治疗的疗效,寻求胶质瘤治疗的新方法.方法对资料完整的41例胶质瘤患者进行回顾性分析研究,其中低分级胶质瘤23例,高分级胶质瘤14例,少突胶质细胞瘤4例,手术全切29例,次全切12例,20例接受放疗合并颈动脉灌注综合治疗,21例单纯放疗,寿命表法计算生存率并绘制生存曲线.结果综合组及单放组的中位生存期分别为17个月、10个月,kaplan-meier生存曲线分析显示:综合组的生存情况明显高于单放组(1og Rank检验P＜0.05).结论在脑胶质瘤术后放疗过程中同步使用颈动脉灌注榄香烯可改善患者生存时间.

目的 验证国产微型柱状1 92 Ir放射源剂量分布特性 ,比较其与点源剂量分布特性的偏差。方法 用电离室法与胶片法实测国产1 92 Ir放射源空间剂量角分布、点源的近似性与源强反平方定律的符合性以及水介质散射与衰减特性 ,并与点源剂量分布特性比较。结果 （1）空间剂量角分布在距源中心 ＜1cm处为近似圆形 ,距源中心较远时呈苹果剖面形 ,测量半径对剂量角分布测量结果有一定影响 ;（2 ）源在空气中剂量衰减与源强反平方定律比较 ,在距源中心 ＜4cm范围内 ,其偏差值≤ 3 % ,但随着距离增大 ,偏差值增大 ;（3）水介质散射与衰减特性与Meisberger多项式计算值比较 ,距离源中心 ＜5cm范围偏差较小 ,最大偏差为 0 .6 2 % ,距离较远时偏差较大 ,最大偏差为 3.5 0 %。结论 1 92 Ir放射源在距离源中心较近范围 ,剂量分布特性较好 ,距离较远时有一定偏差