鼻咽癌颈部转移性淋巴结诱导化疗后彩色多普勒超声影像学分析及意义  

The performance of color doppler flow imaging of cervical lymph nodes metastasized from nasopharyngeal carcinoma after induction chemotherapy

作　　者：朱雪莲[1] 陈顺平[1] 郑华敏[1] 

机构地区：[1]温州医学院附属第一医院超声科,浙江省温州325000

出　　处：《中国基层医药》2013年第12期1778-1780,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 观察鼻咽癌颈部转移淋巴结诱导化疗前后的二维及彩色多普勒超声（CDFI）影像学表现,并预测转移淋巴结在序贯放疗后的近期疗效。方法 40例经病理和CT证实为鼻咽癌初治患者颈部转移性淋巴结65枚,运用超声观测其大小、收缩期峰值流速（PSV）、阻力指数（RI）,并记录其内部血流分级,分别在化疗前、后及序贯放疗后1～2个月行超声检查,比较转移淋巴结各测值及疗效的差异。结果 根据诱导化疗前后颈部转移淋巴结内血供改变分三组,血供改善组占55%（36/65）,血供减少组和血供无变化组分别占23%（15/65）、22%（14/65）,诱导化疗及序贯放疗后淋巴结均缩小,化疗后平均退缩率在血供减少组、血供改善组、血供无变化组分别为52%、36%、25%,序贯放疗后分别为90%、81%、70%,三组间均呈递减趋势,差异有统计学意义（P＜0.05）。化疗后淋巴结血供变化与化疗后退缩率间有相关性（r=0.572,P=0.000）,与序贯放疗后退缩率间有相关性（r=0.553,P=0.000）,化疗后淋巴结退缩率与序贯放疗后退缩率间有相关性（r=0.621,P=0.000）。化疗后淋巴结RI均下降,与治疗前差异有统计学意义（P＜0.05）;化疗后血供减少组、血供改善组PSV与治疗前差异有统计学意义（P＜0.05）,血供无变化组差异无统计学意义（P＞0.05）。结论 应用CDFI可清晰、准确地观察鼻咽癌颈部转移性淋巴结诱导化疗前后的变化,其中诱导化疗后血供、大小的变化可预测近期放化疗后的疗效。Objective To observe the performance of two-dimensional echocardiography and CDFI of metastatic cervical lymph nodes in nasopharyngeal carcinoma before and after induction chemotherapy,and to predict the short-term effect of the lymph nodes after sequential chemoradiotherapy.Methods Forty patients with sixty-five metastatic cervical lymph nodes which were confirmed as nasopharyngeal carcinoma by biopsy and CT were studied.CDFI was used to observe its size,the peak systolic velocity（PSV）,resistivity index（RI）,and record its classification of blood flow before and after induction chemotherapy,after radiotherapy 1 to 2 months for ultrasound,respectively,and the measured values and short-term effect in cervical lymph node metastasized were compared.Results According to the changes of blood supply after induction chemotherapy,lymph nodes were divided into three groups,the group of improve blood supply was given priority（55%）,blood supply to reduce and no change groups were 23%,22%,respectively.After induction chemotherapy and sequential radiotherapy,all lymph nodes were narrow,regression rate after induction chemotherapy in blood supply to reduce,improve and no change groups were 52%,36%,25%,respectively,the regression rates of sequential chemoradiotherapy were 90%,81%,70%,respectively,among three groups are in degressive tendency,differences were significant（P〈0.05）.The blood supply changes after induction chemotherapy related well with the regression rate of chemotherapy（r=0.572,P=0.000） and sequential radiotherapy（r=0.553,P=0.000）.The regression rate of chemotherapy related well with the regression rate of sequential chemoradiotherapy（r=0.621,P=0.000）.After chemotherapy three groups of lymph node RI decreased,the difference was significant compared with that before treatment（P〈0.05）.After chemotherapy the groups to reduce and improve of PSV had significant differences compare with that before treatment（P〈0.05）,the group of blood supply no change of PSV had no significant di

关 键 词：鼻咽肿瘤 颈部转移性淋巴结 血供变化 近期放化疗效应 

分 类 号：R739.63[医药卫生—肿瘤]