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放射性肺损伤是肺恶性肿瘤放疗后常见的并发症,其限制肺恶性肿瘤的放疗剂量并影响总体疗效及患者生存质量。本文复习放射性肺损伤发生机制及影响因素,分析剂量体积直方图、肺功能测定、TGF-β1等临床常用放射性肺损伤评估指标的利弊。参考近年文献,总结了单光子发射计算机断层扫描肺灌注显像(SPECT/CT)在肺恶性肿瘤放疗中的应用,从其原理、区域肺功能的显像、对放疗的评估与指导应用几方面阐述。认为SPECT/CT能实时反映区域肺功能、肺功能改变以及其解剖定位,可在放疗中起监测作用,对准确评估肺功能、预测放疗后肺损伤,优化放疗计划有重要价值。SPECT/CT肺灌注显像还需要多中心、大样本、长时间随访资料进一步深入研究。
Radiation lung injury is a common complication after radiotherapy for lung malignancies, which limits the radiation dose to lung malignancies and affects the overall efficacy and quality of life of patients. This review of the pathogenesis of radiation-induced lung injury and its influencing factors, analysis of the dose-volume histogram, lung function test, TGF-β1 and other clinical radiation injury assessment of the pros and cons of common indicators. With reference to recent literatures, the application of single photon emission computed tomography perfusion imaging (SPECT / CT) in the radiotherapy of lung malignant tumors is summarized. From the aspects of its principle, imaging of regional pulmonary function, assessment and guidance of radiotherapy Explain. It is considered that SPECT / CT can reflect regional pulmonary function, pulmonary function and anatomic localization in real time, which can play a monitoring role in radiotherapy. It is of great value to accurately evaluate pulmonary function, predict lung injury after radiotherapy and optimize radiotherapy plan. SPECT / CT lung perfusion imaging also need more centers, large samples, long-term follow-up data for further study.