剪切波弹性成像定量评价鼻咽癌放疗后颈部软组织纤维化研究  

Quantitative measurement of elastic modulus of neck soft tissue fibrosis by shear wave elastography after radiotherapy for nasopharyngeal carcinoma

作　　者：何炼图[1] 汤庆[1] 廖健鸿 刘敏[1] 张晓云[1] 

机构地区：[1]广州医学院第一附属医院超声科,510120 [2]香港威尔斯亲王医院影像与介入放射科

出　　处：《实用医学杂志》2013年第15期2478-2481,共4页The Journal of Practical Medicine

摘　　要：目的:探讨剪切波弹性成像定量评估鼻咽癌放疗后颈部软组织纤维化的可行性和临床应用价值。方法:使用法国Supersonic公司的AixPlorer型实时定量剪切波弹性成像诊断仪,分别对30例鼻咽癌放疗后颈部软组织纤维化患者(观察组)和30例同时期体检健康者(对照组)颈部软组织进行检测,在相同条件下对比分析两组颈部皮下组织、肌肉、涎腺、甲状腺的杨氏模量值。结果:(1)鼻咽癌放疗后观察组双侧颈部皮下组织、胸锁乳突肌的杨氏模量平均值,与对照组比较各项数值有明显增高:L-Sub 71.74±60.71 vs 11.79±5.74、R-Sub 84.09±87.97 vs 13.54±6.46、L-SCM 85.63±56.32 vs 18.53±5.03、R-SCM 81.02±66.33 vs20.20±5.84,P值均小于0.05,表明鼻咽癌放疗后观察组双侧颈部皮下组织和胸锁乳突肌的质硬度即纤维化有了明显增高;(2)对照组和观察组双侧颈部颌下腺、腮腺、甲状腺的杨氏模量平均值比较:L-subman7.27±1.46 vs 7.73±3.38、R-subman 6.34±1.65 vs 6.18±2.60、L-partotid 5.77±1.25 vs 6.90±3.31、Rpartotid 6.01±1.03 vs 6.91±2.09、L-thy 8.12±2.46 vs 7.87±4.19、R-thy 7.47±2.13 vs 7.81±2.80,P值均大于0.05,提示放疗对涎腺、甲状腺的质硬度或纤维化没有明显的影响。结论:剪切波弹性成像技术具有足够的灵敏度,可客观地量化鼻咽癌放疗后的软组织纤维化,具有定量评价纤维化程度、分级的临床应用潜力。Objective To investigate the feasibility and clinical value of shear wave elastography in quantitative assessment of neck soft tissue fibrosis in patients after radiotherapy for nasopharyngeal carcinoma. Methods The Supersonic AixPlorer real-time quantitative diagnostic shear wave elastography was used to detect the neck soft tissues in 30 healthy controls （control group） and 30 patients with nasopharyngeal carcinoma after radiotherapy （study group）. Under the same condition, bilateral neck subcutaneous tissue, muscle, young＇s modulus value of salivary gland, thyroid were analyed and compared. Results Neck fibrosis of bilateral neck subcutaneous tissue, sternocleidomastoid, young＇s modulus on average increased significantly in the study group as compared with the control group. L-Sub 71.74 ± 60.71 vs. 11.79 ± 5.74, R-Sub 84.09 ± 87.97 vs. 13.54 ± 6.46, L-SCM 85.63 ± 56.32 vs. 18.53 ± 5.03, and R-SCM 81.02 ± 66.33 vs. 20.20 ± 5.84, Pvalues were less than 0.05, which indicates that bilateral neck neck fibrosis after NPC radiotherapy and sternocleidomastoid mass subcutaneous tissue hardness or fibrosis were increased obviously. Healthy controls and neck fibrosis group of bilateral neck submandibular gland, parotid gland, thyroid young＇s modulus onaverage were L- subman 7.27 ± 1.46 vs. 7.73 ± 3.38, R- subman 6.34 ± 1.65 vs. 6.18 ± 2.60, L- partotid 5.77 ± 1.25 vs. 6.90 ± 3.31, R- partotid 6.01 ±1.03 vs. 6.91 ± 2.09, L- thy 8.12 ± 2.46 vs. 7.87 ± 4.19, and R- thy 7.47 ± 2.13 vs. 7.81 ± 2.80, P values were more than 0.05, suggesting radiation therapy had no obvious impacts on salivary gland, thyroid mass hardness or fibrosis. Conclusions Shear wave elastography has enough sensitivity, can objectively quantify the soft tissue fibrosis of NPC after radiotherapy, and has potential clinical application in quantitative evaluation of the grading and classification of of fibrosis.

关 键 词：鼻咽肿瘤 放疗并发症 颈部软组织纤维化 剪切波弹性成像 杨氏模量 定量评估 

分 类 号：R739.63[医药卫生—肿瘤]