MKSA X 6 MKSA 1kg 1 X 1.02MeV 0.51MeV X C/kg 1GyGray SvSievert 4 GyGray C/kg X X 5 X X X 3 SVSievert 0.51MeV contrast 2 X X 2 X 2 n 2 0.51MeV X n bit X 1-3 X 8 bit 2 8 3 X X X 256 sharpness X 110 130kVp X 3 X 1/ 2 X X CRT X 20 30kVp 6 7
1-24 acoustic neurinoma schwannoma T1 CT 13 Schwann Schwann T1 1 1-25 2 MRI T1 T2 14 T1 von Hippel-Lindau von Hippel-Lindau von Hippel-Lindau epidermoid hemangioblastoma metastatic brain tumor J 15 von Hippel-Lindau 1 2 CT MRI 1-27 T2 1-26 p.59 von Hippel-Lindau 1 44 45
S 1 S 1+2 S 2 S 3 S 3 S 4 S 5 S 4 S 4 S 5 S 5 3-15 2 4 56 3-16 57 S 6 S 9 S 8 S 10 S 7 S 6 S 10 S 8 S 9 CT 2 3-17a d 3-17a 3 104 105
spicula notch sign notch spicula 78 pleural indentation 3-60 CT pulmonary lymphoma X CT J 77 3-62 large cell carcinoma metastatic lung tumor 3-61 hematogenous metastasis 6cm X CT S 3 small cell carcinoma X 3-59 76 lung adenocarcinoma X CT 128 129
4-6 4-4 CT MRI 4-3 CT 4-5 4-6 4-4 cine-mri a b 4 4 SVC RVOT AAo LA LCA RCA RA RV LV LA MV DAo PV DAo c d RCA RV RCA RV LV RA LV IVC LA DAo DAo a b c 4 d LV RV RVOT LA RA AAo DAo PV SVC IVC LCA RCA T1 166 167
CT 6-38 CT CT 2cm CT T1 6-39 T2 2cm CT CT CT CT MRI CT MRI MRI T1 CT MRI T2 2cm T1 6-37 halo lateral shadow 7 6-4044 242 243
wrist joint 2 hip joint shoulder joint X 8-9 8-12 pronation supination 8-11 MRI Perthes elbow joint MRI 1 1 8-8 8-10 1/3 fat pad sign 1 2 3 4 5 6 7 1 2 3 1 2 3 4 5 1 2 3 4 5 6 7 4 5 6 7 8 9 6 7 8 9 1 10 2 5 306 307
particle beam radiosensitivity reoxygenation 1 therapeutic ratiotr DNA Bragg 4 R 2 repairrepopulationredistribution kg reoxygenation J - Gy1Gy 1J/kg 1-1 1 fractionated irradiation 1 cm 1 1 1.8 2Gy 5 8 Bergonié-Tribondeau repair definitive radiation therapy 1 100 50 40 60 80Gy 100 50 40 60 80Gy repopulation 5 redistribution 1 348 349
10 9 8 7 6 5 4 3 2 1 three-dimensional conformal radiation therapy3d CRT 2.0 4.0 6.0 8.0 1 12.0 14.0 16.0 18.0 2 22.0 24.0 26.0 28.0 3 32.0 34.0 36.0 38.0 4 42.0 44.0 46.0 48.0 5 52.0 54.0 56.0 58.0 6 62.0 64.0 66.0 68.0 7 72.0 74.0 76.0 3.0 6.0 9.0 12.0 15.0 18.0 21.0 24.0 27.0 3 33.0 36.0 39.0 42.0 45.0 48.0 51.0 54.0 57.0 6 63.0 66.0 69.0 72.0 75.0 78.0 81.0 84.0 87.0 9 93.0 96.0 99.0 102.0 105.0 108.0 Gy DVH 7DVH PTV 10 9 8 7 6 5 4 3 2 1 PTV PTV PTV 1-4 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 IMRT intensity-modulated radiation therapyimrt IMRT 3D CRT IMRT 3D CRT 3.0 6.0 9.0 11.0 14.0 17.0 2 23.0 26.0 29.0 31.0 34.0 37.0 4 43.0 46.0 49.0 51.0 54.0 57.0 6 63.0 66.0 69.0 71.0 74.0 77.0 8 Gy 3D CRT 3D CRT PTV IMRT PTV DVH IMRT3D CRTPTV DVHIMRT 1-5 354 355
a b T1 2cm T2 T3 T4a T4b 2cm 4cm 4cm N0 N1 3cm N2a 3 6cm N2b 6cm N2c N3 6cm M0 M1 c d 5 35 60 60 90 15 60 80 90 40 60 60 70 30 60 50 90 10 40 30 70 5 20 80 95 35 60 IMRT GTV 6070Gy67 31 6070Gy67 33 2-4 60 70Gy 1 54 70Gy 6 7 30 40 2-5 60 70Gy 6 7 30 35 2-1 3Gy/ 10 30Gy 2-4 362 363