SU1489724A1 - Method of locating pathological brain growth for radiation therapy - Google Patents

Description

The invention relates to neuro x-ray. The purpose of the invention is the reduction of complications and simplification of the method for determining the pathological

brain formation. The angiograms of the skull are obtained when the main beam passes through the top of the back of the Turkish saddle, taking into account the coefficient. The invention relates to medicine, namely to neuro-roentgenology.

The aim of the invention is to reduce complications and simplify the method by combining marked angiograms with reference points of the head of the subject with subsequent adjustment of the target point during irradiation.

The method is as follows

in a way.

In the lateral projection of the patient produce stereotactic angiographic study at standard distances: x-ray tube - x-ray film - head

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that increase angiogram determined distance from the top of the sella turcica back to the lesion center further detected in angiogram rentgenoanatomicheskip bony landmark carried rektgenokoptrastnuyu marking identified on an angiogram of reference points, parallel to the sagittal plane of the patient's head mounted labeled angiogram superposed marked reference points on the angiogram with soot ' the patient’s anatomical landmarks, irradiation is performed by combining the main beam X-ray vskogo stimulator with a marked center of the lesion. The method allows to precisely localize the point to induce proton ka, to simplify the process of alignment

proton irradiation of intracranial X-ray occlusion.

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patient in a rectangular coordinate system. Before the examination, the central beam of the X-ray tube is centered on the reference point - the top of the back of the Turkish saddle. On the obtained angiogram determine the point of the target and connect the last line with the center of the central x-ray. ray beam. Using the scale bar, the distance between the central x-ray point and the target point is measured. Further, this distance is laid on the line connecting the ’point of the target with the centering point of the central x-ray beam at> 44489724

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the powers of the ruler with the metric scale and determine the orthogonal projection of the target point. At the same time, on the angiogram, the most clearly identified bone landmark is selected, for example, the anterior sphenoid process, which is further used in the stereotaxic irradiation procedure to align the angiogram with the patient's head.

In direct projection, an angiographic study is also performed at standard distances, an X-ray tube — the patient's head — an X-ray film. The central beam of the x-ray tube is centered on the top of the nasal dorsum, which is labeled with a radiopaque marker. On the received antiograms determine the point of the target, the distance to which from the point is measured using a scale bar. A line equivalent to that obtained using a ruler with a metric scale is laid on the line of connection of these points, and a line parallel to the mid-sagittal line is drawn through the obtained point. The distance between the mid-sagittal line and the line passing through the target point on a metric scale is entered into the coordinate system of the stand's stereotactic installation for irradiation.

The stereotactic guidance of the proton beam is carried out on a stereotactic device with two mutually perpendicular pairs. X-ray tube is an electron-optical converter and an X-ray transparent cassette to hold the angiogram. Stereotactic установка installation of the irradiation stand is designed so that the axis of the proton beam strictly corresponds to the central beam of the beam.

During stereotactic irradiation of an intracranial target, the patient's head is placed on the head restraint in a comfortable position for the patient, with the condition of perpendicularity of the mid-sagittal plane and the plane of the table 50 of the stereotactic device. The central beam of the x-ray tube is adjusted to a reference point - the top of the back of the Turkish saddle. A radiograph is inserted into a special radiolucent cassette-55 with radiopaque markers previously attached to it at specific points. Under x-ray control produce the combination of images of points on the patient's skull with similar points on the angiogram by moving the angiogram. At the same time, the target point will be combined with its orthogonal projection on the angiogram. Focusing on the X-ray image of the radiopaque point marker, the proton beam is concentrated on it by moving the table of the stereotactic device.

Example 1. Patient R. was admitted to the hospital after subarachnoid hemorrhage. During the examination she was diagnosed with arteriovenous malformation. The proposed method marked the lower parts of the malformation and made an adjustment of the target point, followed by targeted irradiation of arteriovenous malformation with a proton beam. The method allows you to simultaneously carry out diagnostic antiography and the procedure of pre-radiation preparation, to reduce the time of the survey, to exclude additional trauma to the patient and to reduce the radiation load on the staff. One year after irradiation, an angiographic control study revealed the obliteration of the vessels of the lower AVM section, which were irradiated, and at the same time there was a significant regression of neurological symptoms, which confirms the accuracy of stereotactic guidance of the proton beam.

Example 2. Patient B. was admitted to the hospital 3 months after subarachnoid hemorrhage. During the examination, he was diagnosed with arteriovenous malformation of the right visual hillock and internal brain capsule. By the proposed method, it was labeled and totally irradiated with a proton beam. 1.5 years after irradiation with an angiographic study of vascular contrast, there are no pathological changes. Control computed tomography revealed a site of a decrease in the density of tissues according to the localization of malformation.

Example Patient K, was admitted to the clinic after 8 months. after severe subarachnoid hemorrhage. Arteriovenous was diagnosed

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malformation of subcortical nodes on the left. By the proposed method, it was labeled and totally irradiated with a proton beam. A follow-up angiographic examination 2 years after irradiation revealed complete thrombosis of malformation vessels.

Thus, the proposed method allows to precisely localize the Delhi point, produce stereotactic guidance of the proton beam, as well as simplify the alignment process during proton irradiation of radiopaque intracranial formations and eliminate patient trauma.

Claims (1)

Claim The method of determining the pathological formation of the brain for radiation therapy by angiography, stereotactic research, characterized in that, in order to reduce complications and simplify the method, angiograms of the skull are produced when the main beam passes through the top of the back of the Turkish saddle, taking into account the magnification factor of the angiogram, determine the distance from the top of the back of the Turkish saddle to 10 of the center of the lesion, additionally identify on the angiogram x-ray anatomical bone landmark, conduct radiopaque marking identified on the angiogram of the reference 15 points, parallel to the sagittal plane of the patient's head, set the marked angiogram, combine the marked reference points on the angiogram with the corresponding patient anatomical reference points, and the light is produced when the main beam of the X-ray stimulator is combined with the marked center of the lesion.