莊濬超沈昱辰Yu-Chen Shen生物醫學科學學系碩士班2026-03-189999-12-312016https://handle.ncl.edu.tw/11296/84a9hbhttps://scholars.csmu.edu.tw/handle/123456789/5921研究目的：呼吸門控是一個偵測呼吸訊號來調控攝影的方法，因為呼吸會影響我們體內的器官移動，而在現在臨床上，會將呼吸門控運用在各種檢查治療上面。然而每個人有不同的呼吸習慣，不同的呼吸方式對體內器官的變化也有所不同。所以在這篇研究中，我們要透過磁振造影技術，取得Anterior－Posterior（AP）方向肺部影像，找出在不同呼吸模式下，與體內橫膈變化相關性最大的體外呼吸綁帶位置。材料與方法：受試者共28位，分為13位女性與15位男性，使用西門子1.5Tesla MRI 做Fast low angle shot(FLASH)波序掃描，TR= 2.18 ms, TE= 0.74 ms, slice thickness=10mm, field of view(FOV)= 350mm，每組共511張，經計算每秒取得4.02張影像。透過影像導引，每位受試者每次取樣做3種掃描，分為胸式呼吸、腹式呼吸、自由呼吸。由上而下將胸部影像分成A、B、C、D、E五段，分別代表呼吸綁帶的位置，透過透過LabVIEW以及SPSS軟體分析，比較三種呼吸模式下綁帶位置與橫膈膜變化的關係。結果：三種呼吸模式下均一化後的橫膈變化，在腹式呼吸時，橫膈變化量平均值為0.997，標準差為0.274；在胸式呼吸時，橫膈變化量平均值為1.104，標準差為0.180；在自由呼吸時，橫膈變化量平均值為0.992，標準差為0.338。胸式呼吸有一個較大的橫膈變化量與較小的標準差。在體外變化，三種呼吸的變化量大都介於0.9左右，而標準差則是在0.2左右，均相差不大。在胸式呼吸時，體外與體內的相關性均較腹式呼吸高，約在0.8左右，但是在最下面的腹部區域時便會發現，胸式呼吸與腹式呼吸相關性方面差異不大，P-value等於0.548。通過比較胸式呼吸與腹式呼吸的相關性，在A、B、C、D中，兩組數據均有顯著差異，P-value小於0.05。結論：由本研究實驗結果可以得知，胸式呼吸其體廓的變化與體內橫膈位移有較穩定的相關性。腹式呼吸只有在腹部位置有較佳的相關性存在。在進行門控放射治療時，將綁帶置於腹部，體外體內相關性較高。因此建議患者進行穩定的胸式呼吸確保體內變化的穩定性。Purpose:Respiratory gating is a method of modulating imaging with detecting breath signal. Respiratory affects our internal organs movement, so that we usually use the respiratory gating in clinical examinations and treatments. However, everyone has different breathing habits, and It makes internal organ with different movement. Therefore, we through MRI technology to achieve lung imaging between anterior to posterior direction. Then we find out the maximum relativity between breathing strap position and diaphragmatic movement in different breathing patterns. Materials and Methods:We have 28 voluntary healthy subjects. They divided into 15 males and 13 females. We chose the more stable group of 20 to use in this research. This study used the SIEMENS 1.5Tesla MRI in Zhong－Shan Medical University Hospital. The sequence is Fast low angle shot(FLASH). TR= 2.18 ms, TE= 0.74 ms, Slice thickness=10 mm, field of view= 400 mm, 4.02 images per sec, total 511 images.We guided subjects to get on thoracic breathing, abdominal breathing, and free breathing by image guiding. The position A, B, C, D, and E preset to be the strap location where we set in clinical. With 5 line of the strap position, we can get the changes in chest expansion. Then, comparing the relation for three different types of respiratory and diaphragm motion with LabVIEW and SPSS analysis.Results:We find that their normalized average displacements have little difference, abdominal breathing is 0.997 and normal breathing is 0.992. But in thoracic breathing, the average displacement is 1.104. When people use thoracic breathing, they may have a larger and more stable internal motion. It is very small average displacement in normal breathing whether where the line was set. All values are less than 0.1. In abdominal breathing, the average values gradually increase in the order of A to E. the p-value are smaller than 0.001 in A, B, and C. It means there is a significant difference between two sets of data. Especially, there is a quite large p-value in E, it expresses that they are similar in E between abdominal and thoracic.Conclusion:There is a more stable correlation between thoracic movement and internal diaphragmatic motion in thoracic breathing. Abdominal breathing only has higher correlations in the abdomen position. During radiotherapy gated, it is a higher correlation between internal to external when we put the strap on the abdomen position. We suggest that using thoracic breathing to ensure the stability of the in vivo changes.呼吸導引門控橫膈位移respiratory gatedmagneticresonance imageimage guidethesis