瞬时波强技术评价头颈部肿瘤患者放射治疗后颈动脉弹性及左心室收缩功能变化  

Evaluation of carotid artery elasticity and left ventricular systolic function changes in patients with head and neck neoplasm after radiotherapy

作　　者：杨岫岩[1] 林萍[1] 邹丽娟[2] 张卓[2] 查建栋 邱志敏[1] 邹蕊[1] 

机构地区：[1]大连医科大学附属第二医院超声科,辽宁大连116027 [2]大连医科大学附属第二医院放疗科,辽宁大连116027

出　　处：《中国医学影像技术》2015年第8期1198-1201,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨应用瞬时波强(WI)技术评价头颈部肿瘤患者放疗后颈动脉弹性及左心室收缩功能改变的价值。方法对39例经病理检查证实的头颈部恶性肿瘤患者于放射治疗前及治疗后行常规超声心动图、颈动脉常规超声及WI检查。常规超声心动图及颈动脉常规超声指标包括左心室射血分数(LVEF)、舒张早期峰值血流速度(E)与舒张晚期峰值血流速(A)的比值(E/A),颈动脉阻力指数(RI)、搏动指数(PI)、内-中膜厚度(IMT);WI指标包括瞬时加速度波强(W1)、瞬时减速度波强(W2)、僵硬度(β)、血管压力应变弹性系数(Eρ)、脉搏波传导速度(PWVβ)、顺应性(AC)、负相波面积(NA)。颈总动脉超声测值取双侧颈总动脉平均值。统计学分析放射治疗前后常规超声及WI指标变化,并分析放射治疗后各指标间的相关性。结果放射治疗前与治疗后LVEF、E/A、RI、PI、IMT差异均无统计学意义(P均>0.05)。W1、W2、β、Eρ、PWVβ放射治疗后均较治疗前增高(P均<0.05),AC较治疗前减低(P<0.05),治疗前后NA差异无统计学意义(P>0.05)。放射治疗后IMT与β、Eρ、PWVβ呈正相关(r=0.870、0.330、0.427,P均<0.05),W1与LVEF呈正相关(r=0.347,P<0.05);余各指标间无相关性(P均>0.05)。结论头颈部恶性肿瘤患者放疗后颈动脉弹性减低,WI可早期反映颈动脉弹性改变,且有助于评估放疗所引起的左心室收缩功能改变。Objective To explore the value of the wave intensity （WI） technique in evaluating the changes of carotid ar- tery elasticity and left ventricular systolic function in patients with head and neck malignant tumors after radiotherapy. Methods Totally 39 cases of head and neck malignant tumors confirmed by pathology underwent conventional echocardio- graphy, conventional ultrasound of carotid arteries and WI scan before and after radiotherapy. Left ventricular ejection frac- tion （LVEF）, the ratio of peak early diastolic velocity （E）and late diastolic velocity （A）, resistance index （RI）, pulsatility index （PI） and intima-media thickness （IMT） of carotid were measured with conventional echocardiography and conven- tional ultrasound of carotid arteries. WI parameters included acceleration wave intensity （W1）, deceleration wave intensity （W2）, stiffness parameter （β）, pressure strain elasticity modulus （Ep）, pulse wave velocity （PWVI3）, arterial compliance （AC） and negative area （NA）. Taking average value of bilateral carotid artery as carotid artery ultrasound measurement values, the parameters of conventional ultrasound and WI before and after radiotherapy were compared. Furthermore, the correlation of each parameter after radiotherapy were analyzed. Results No significant diference of LVEF, E/A, RI, PI, IMT was found before and after radiotherapy （all P〉0.05）. After radiotherapy, all of W1, W2, β, Eρ and PWVβ in- creased （all P〈0.05）, while AC decreased （P〈0.05）. There was no significant diference of NA （P〉0.05）. Positive correlations were found between IMT and 13, Eρ, PWVβ （r=0. 870, 0. 330, 0. 427, all P〈0.05） as well as between W1 and LVEF （r=0. 347, P〈0.05） after radiotherapy. There was no correlation among another parameters （all P 〉0.05）. Conclusion After radiotherapy, the carotid elasticity in patients with head and neck malignant tumor decreases. WI tech- nique can reflect abnormal changes of carotid artery

关 键 词：超声检查 头颈部肿瘤 放射疗法 颈动脉 瞬时波强 

分 类 号：R54[医药卫生—心血管疾病] R445.1[医药卫生—内科学]