定量组织速度成像技术对于评估乳腺癌新辅助化疗导致心肌损害的临床价值  

Clinical significance of quantitative tissue velocity imaging in evaluating myocardial damage caused by neoadjuvant chemotherapy in breast cancer

作　　者：蔡丽珊[1] 张建兴 陈洁[1] 陈钰仪[1] 万蓉[1] CAI Lishau;ZHANG Jiauxiug;CHEN Jie;CHEN Yuyi;WAN Rong(Department of ultrasound,the First Hospital,Guangzhou Traditional Chinese Medicine,Guangzhou 510405,China)

机构地区：[1]广州中医药大学第一附属医院超声科,广州510405 [2]广州中医药大学第二附属医院超声科,广州510120

出　　处：《实用医学杂志》2018年第16期2770-2772,共3页The Journal of Practical Medicine

基　　金：广东省中医药管理局科研基金(编号:20151197)

摘　　要：目的探讨定量组织速度成像(QTVI)技术在乳腺癌患者新辅助化疗所致心肌损害的价值意义。方法观察50例术前接受蒽环类新辅助化疗乳腺癌患者化疗前、化疗4周期后及化疗8周期后的心脏超声表现,观察LVDd、LVDs、IVSTd、LVPWTd、LVEF、LVFS及E/A等常规超声心动图表现。通过QTVI测量左心室壁基底段心肌的各个位点收缩期、舒张早期和舒张末的峰值速度(Vs、Ve、Va)。结果常规超声心动图结果提示:化疗8周期后舒张功能指标E/A降低,与化疗前差异有统计学意义(P<0.05)。QTVI法测量结果提示:化疗4周期后,室间隔、后壁、下壁及侧壁的Ve值与化疗前差异有统计学意义(P<0.05);前间隔、前壁、后壁、下壁及侧壁的Va值与化疗前差异有统计学意义(P<0.05)。化疗8周期后,Vs、Ve及Va值与化疗前及化疗4周期后差异均有统计学意义(P<0.05)。结论常规的超声心动图及QTVI在评价心脏舒张功能中均具有一定的价值意义,但QTVI能更早、更为准确发现舒张功能的改变,较常规超声心动图更为敏感,同时QTVI可发现收缩功能的改变。Objective To evaluate the significance of quantitative tissue velocity imaging （QTVI） tech- nique in myocardial damage induced by neoadjuvant chemotherapy in breast cancer patients. Methods The echo- cardiographic manifestations were performed in 50 cases of breast cancer patients received anthracycline neoadju- vant chemotherapy before and after chemotherapy, 4 cycles of chemotherapy and 8 cycles of chemotherapy were observed. The routine echocardiographic features of LVDd, LVDs, IVSTd, LVPWTd, LVEF, LVFS and E/A were determined. Systolic, diastolic and peak velocities of diastolic end （Vs, Ve, Va） were measured by QTVI. Results The results of routine echocardiography showed that the E/A of diastolic function decreased after 8 cycles of chemotherapy, which was significantly different from that before chemotherapy （P 〈 0.05 ）. The results of QTVI measurement showed that the Ve values of the ventricular septum, the posterior wall, the lower wall and the lateral wall were significantly different after 4 cycles of chemotherapy （P 〈 0.05, respectively）, as well as the Va values of the anterior septum, the anterior wall, the posterior wall, the lower wall and the lateral wall were statistically significant （P 〈 0.05, respectively）. After 8 cycles of chemotherapy, the values of Vs, Ve and Va were signifi- cantly different fi＇om those before chemotherapy and after 4 cycles of chemotherapy （P 〈 0.05, respectively）. Conclusion Both routine echocardiography and QTVI have some value in evaluating cardiac diastolic function. Moreover QTVI can detect the changes of diastolic function earlier and more accurately, which is more sensitive than conventional echocardiography. Meanwhile, QTVI can indicate the change of contraction function.

关 键 词：定量组织速度成像 乳腺癌新辅助化疗 心肌损害 

分 类 号：R737.9[医药卫生—肿瘤] R540.45[医药卫生—临床医学]