彩色多普勒超声与触诊对鼻咽癌放疗后颈部肿物诊断的比较  

Comparison of color Doppler ultrasonography with palpation in diagnosis of recurrent neck neoplasms following radiotherapy in nasopharyngeal carcinoma

作　　者：徐晓红[1] 廖思海[2] 刘锋[1] 温赐祥[1] 廖桂英[1] 杨志雄[2] 

机构地区：[1]广东医学院附属医院超声科,广东湛江524001 [2]广东医学院附属医院放射治疗科,广东湛江524001

出　　处：《广东医学院学报》2005年第4期370-372,共3页Journal of Guangdong Medical College

摘　　要：目的:比较彩色多普勒超声(CDFI)与临床触诊对鼻咽癌放疗后颈部肿物的诊断价值。方法:84例鼻咽癌根治性放疗后又出现可疑颈部包块者行临床触诊、CDFI和穿刺活检。以病理学诊断为金标准,评价触诊和CDFI对肿瘤复发与放射性纤维化诊断的敏感性和特异性。结果:(1)105个颈部肿物中,64个为复发肿物,41个为纤维化改变;(2)临床触诊发现颈部肿物92个,诊断的敏感性为61.9%,特异性为73.8%,符合率为66.7%;(3)CDFI检出颈部肿物105个,诊断的敏感性为92.2%,特异性为85.4%,符合率为89.5%;(4)复发组的纵、横径比值(L/T)明显小于纤维化组,但峰值血流速度、舒张末期血流速度和阻力指数明显增高(P<0.01)。结论:CDFI对鉴别鼻咽癌放疗后颈部肿瘤复发与放射性纤维化的价值明显优于临床触诊。Objective：To compare the diagnostic value in recurrent neck neoplasms between color Doppler flow imaging （CDFI） and palpation following nasopharyngeal carcinoma （NPC） radiotherapy. Methods： CDFI and palpation were used to detect the recurrent neck masses in 84 NPC patients undergoing radiotherapy, and aspiration biopsy was performed on them by ultrasound localization. According to the pathological examination, a golden standard, the sensitivity and specificity of CDFI and palpation in the diagnosis of relapsing tumors and radiation fibrosis were valuated. Results： There were 64 tumors and 41 fibrosis nodules in 105 recurrent neck neoplasms. Of them, 92 were detected by palpation, and its sensitivity, specificity and coincidence were 61.9%, 73.8% and 66.7%, respectively; 105 were determined by CDFI, and its sensitivity, specificity and coincidence were 92.2%, 85.4% and 89.5%, respectively. L/T ratio decreased, and PSV, EDV and RI increased significantly in relapsing tumors compared with those in fibrosis nodules （P〈0.01）. Conclusion： Compared with the clinical palpation, CDFI is more suitable in the differential diagnosis of recurrent tumors and radiation fibrosis after NPC radiotherapy.

关 键 词：鼻咽肿瘤 放射疗法 复发 纤维化 彩色多普勒血流显像 

分 类 号：R445.1[医药卫生—影像医学与核医学] R739.63[医药卫生—诊断学]