超声检查在鼻咽癌放疗后颈动脉损伤中的应用价值  

Application of color Doppler flow imaging in detection of carotid injury of patients with nasopharyngeal carcinoma after radiotherapy

作　　者：鲁敏[1] 董梁[1] 吴松年[1] 

机构地区：[1]绍兴第二医院超声科,312000

出　　处：《浙江医学》2013年第18期1656-1658,1663,共4页Zhejiang Medical Journal

摘　　要：目的探讨超声检查在鼻咽癌放疗后颈动脉损伤中的应用价值。方法接受放疗并随访2年以上的鼻咽癌患者40例作为放疗组,对照组30例为新诊断还未实施放疗的鼻咽癌患者,应用彩色多普勒超声检查,记录患者颈动脉狭窄部位和狭窄程度,主要检测指标有:颈动脉管腔内径,内膜-中层厚度,斑块部位、大小、形态、回声及颈动脉血流情况,同时分析两组间相关危险因素对疾病的影响。结果两组间相关危险因素如年龄、性别、高血压、高脂血症、高血糖、吸烟等差异均无统计学意义(均P>0.05),但两组间颈动脉损伤发生率差异有统计学意义(P<0.05)。放疗组患者内膜-中层厚度明显大于对照组,发生狭窄情况远远高于对照组。颈动脉狭窄率>50%仅见于放疗组。结论鼻咽癌患者放疗可导致颈动脉的内膜-中层厚度增加、形成斑块继而发生狭窄,而超声检查在颈动脉损伤的早期发现、早期预防及术后疗效评估中具有重要的临床应用价值。Objective To evaluate the application of color Doppler flow imaging （CDFI） in detection of carotid injury of pa-tients with nasopharyngeal carcinoma after radiotherapy. Methods Forty patients with nasopharyngeal carcinoma after radiation （radiation group） and 30 newly diagnosed patients before radiotherapy （control group） underwent CDFI examination. The distri-bution of arterial stenosis and degree of stenosis were documented, with the parameters including vessel internal diameter, thick-ness of intima- media;position, size and shape of plaques, echo and blood flow of carotid artery. The results were compared be-tween radiation and control groups. Other risk factors of carotid injury were also analyzed in these two groups. Results There were no significant differences in age, gender, hypertension, hypercholesterolemia, hyperglycosemia and smoking between two groups（P〉0.05）. Carotid arterial injury was more common in radiation group than that in control group（P〈0.05）. The thickness of intima- media of the radiation group was larger than that of control group. The rate of stenosis in radiation group was higher than that in control group, and the significant stenosis （50%reduction of luminal diameter） was only found in radiation group. Conclu-sion Radiation may increase the thickness of intima- media and plaque formation, leading to significant carotid stenosis. Color Doppler flow imaging（CDFI） is of value in early detection of carotid stenosis.

关 键 词：超声 颈动脉损伤 鼻咽癌 放疗 

分 类 号：R739.63[医药卫生—肿瘤]