鼻咽癌靶区勾画罗伟答题.ppt

鼻咽癌靶区勾画建议; Background;一、鼻 咽 部 MRI 所 见;正常解剖(信号特征）;正常解剖及MR表现：鼻咽腔; ;正常解剖及MRI表现：鼻咽腔;正常解剖及MR表现：鼻咽腔;正常解剖及MR表现：鼻咽腔;正常解剖及MR表现：鼻咽腔;正常解剖及MR表现：鼻咽腔;正常解剖：鼻咽腔;正常解剖及MR表现：鼻咽腔;正常解剖及MR表现：鼻咽腔;正常解剖及MR表现：鼻咽腔;正常解剖及MR表现：咽旁间隙;;;;鼻咽粘膜局限性增厚;鼻咽癌的MR表现:;鼻咽癌的MR表现：肿瘤;鼻咽肿块;鼻咽癌的MR表现：肿瘤; 鼻咽癌的MR表现：肿瘤超腔侵犯 颈动脉鞘区----判断标准;鼻咽癌的MR表现：咽后淋巴结;鼻咽癌超腔侵犯的MR表现：后鼻孔、头长肌; ;鼻咽癌超腔侵犯的MR表现： 蝶骨、枕骨斜坡;鼻咽癌超腔侵犯的MR表现： 蝶骨、枕骨斜坡;鼻咽癌超腔侵犯的MR表现：海绵窦;鼻咽癌超腔侵犯的MR表现：海绵窦;鼻咽癌超腔侵犯的MR表现：颈静脉孔、枕骨;鼻咽癌的MR表现：破裂孔侵犯;鼻咽癌超腔侵犯的MR表现：圆孔;鼻咽癌超腔侵犯的MR表现：蝶窦; ;鼻咽癌的MR表现：颈淋巴结;二、淋巴结分区指引：CTV nd (negative); Background;颈部淋巴CT断层分区; 推 荐 的 边 界;Retropharyngeal nodes (RP)咽后淋巴结;44;45;46;47;Level I a;Level I b;50;51;Level II a;Level II b;Level II;55;Level II;57;58;Level II;60;61;Level III;63;64;Level IV;66;Level IV ;68;Level Va ;The cranial limit of level V;Level V;72;Level IV ;74;75;Level V b ;The caudal limit of level V;78;Level VI ; Level VI;81;82;S c I N;84;85;PTV;Why use surgical guidelines as basic frame of  radiotherapy guidelines?;Why use surgical guidelines as basic frame of radiotherapy guidelines?;Why use surgical guidelines as basic frame of radiotherapy guidelines?;Why use surgical guidelines as basic frame of radiotherapy guidelines?; Guideline of ENI;NPC淋巴引流途径;The first echelon lymph nodes of NPC;Guidelines of CTV nd ;Node - positive ;Node - positive ;Node - positive ;Guidelines of CTVnd;Guidelines of CTV nd ;Suggested guidelines for the treatment of the neck of patients with head and neck squamous cell carcinomas (AJCC 1997) Appropriate node levels to be treated N0 –N1 N2b Nasopharynx II, III, IV, V, II, III, IV, V, and RP and RP;ENI;三、靶区勾画演示;鼻咽癌分期: T4N1M0 MRI T1+C;鼻咽癌分期: T4N1M0 MRI T1 ;鼻咽癌分期: T4N1M0 SAGITAL ;扫描范围：头顶露空至锁骨头下缘2cm 方式：螺旋扫描 Slice wi