目的研究Fletcher宫腔管的不同曲度对宫体周围重要器官受量的影响,为临床医生选择宫腔管治疗时提供参考数据。方法荷兰核通公司生产的Fletcher宫腔管有3种曲度,分别是15°、30°和45°。本研究选取3个临床常用的治疗长度4cm、6cm和8cm,拟设每种管的3个治疗长度的末端均处于子宫颈口,采用Nucletron GENIE TPS(V1.0)进行模拟计划设计,分别记录驻点坐标和驻留时间。然后采用GE LightSpeed 16排CT扫描已插入TLD的仿真盆腔模型,将CT图像经网络传输至基于CT图像的三维后装治疗模拟系统(3DV-TPS),3DV-TPS根椐GENIEV1.0得到的驻点坐标和驻留时间,分别模拟计算3种管在3个治疗长度下的等剂量分布,某一个重要器官在不同治疗条件下的吸收剂量均以同一个坐标点取值。结果在同一个治疗长度下,3种管的器官受量均有差异,其中膀胱上缘的受量差异最大(13%～89%)。膀胱中心(4%～38%)、直肠(1%～12%)、A点(1%～6%)、B点(6%～16%)、F点(4%～25%)、骼外淋巴结(1%～13%)、骼总淋巴结(2%～16%)、卵巢(5%～18%)、股骨(3%～22%)。结论在每次治疗前通过一些医学检查,慎重选择合适曲度的宫腔管是必要的。 Objective To study the effect of different curvature of Fletcher’s uterine canal on the amount of vital organs around the uterine body, and to provide reference data for clinicians to choose uterine canal. Methods Fletcher’s uterine canal of Holland Nuclear has 3 curvatures of 15 °, 30 ° and 45 °, respectively. In this study, three commonly used clinical treatment length of 4cm, 6cm and 8cm, the proposed treatment of three lengths of each tube ends are in the cervix, the use of Nucletron GENIE TPS (V1.0) simulation program design, were recorded Stall point coordinates and dwell time. Then, the GE LightSpeed ​​16-slice CT was used to scan the simulated pelvic model which was inserted into the TLD. The CT images were transmitted through the network to the three-dimensional afterloading treatment simulation system (3DV-TPS) based on CT images. The 3DV-TPS obtained from GENIEV1.0 Point coordinates and dwell time. The isodose distributions of three kinds of tubes under three treatment lengths were simulated respectively. The absorbed dose of one important organ under the different treatment conditions was taken as the same coordinate point. Results Under the same treatment length, the organ weights of the three kinds of tubes differed. Among them, the upper margin of the bladder had the largest difference (13% -89%). (4% -38%), rectum (1% -12%), point A (1% -6%), point B (6% -16%), point F (1% ~ 13%), total lymph nodes (2% ~ 16%), ovary (5% ~ 18%) and femur (3% ~ 22%). Conclusion Before each treatment through some medical examination, carefully select the appropriate curvature of the uterine canal is necessary.