超声弹性成像和超声造影定量在直肠癌新辅助放化疗效果评估中的应用价值  

Application of Quantitative Ultrasound Elastography and Contrast-enhanced Ultrasonography in Evaluation of Neoadjuvant Radiotherapy and Chemotherapy for Rectal Cancer

作　　者：高会蓉 吴朝盛 王华 熊雯[2] GAO Hui-rong;WU Chao-Sheng;WANG Hua(Department of Functional,Anzhou District People's Hospital,Mianyang,Sichuan,621000,China)

机构地区：[1]绵阳市安州区人民医院功能科,四川绵阳621000 [2]四川省人民医院超声科,四川成都610072

出　　处：《医学临床研究》2019年第8期1517-1519,共3页Journal of Clinical Research

摘　　要：【目的】探讨超声弹性成像和超声造影定量在直肠癌新辅助放化疗效果评估中的应用价值。【方法】选择2014年9月至2017年6月在绵阳市安州区人民医院就诊的Ⅱ~Ⅲ期直肠癌患者77例,所有患者均采用手术前新辅助放化疗治疗,治疗前后对患者分别采用超声弹性成像和超声造影定量检查,观察术前后超声指标变化及术后超声评估T、N分期与术后病理的一致性。【结果】治疗后患者直肠肿瘤的前后径(ADT)、整体应变率比值(ESR)和弹力成像评分(UES)水平与治疗前相比较均显著降低,差异均有统计学意义(P<0.05)。治疗后阻力指数(RI)、曲线下面积(AUC)、收缩期峰值流速(PSV)、达峰时间(TTP)均低于治疗前,差异有统计学意义(P<0.05)。新辅助治疗后超声评估T分期和N分期与术后病理检查结果一致性良好(P<0.05),准确度分别为80.82%、82.19%。【结论】超声造影和超声弹性成像可较好地反映直肠癌术前新辅助治疗效果,有利于术前分期的确定和指导个体化治疗。【Objective】To explore the value of ultrasound elastography and contrast-enhanced ultrasound quantification in the evaluation of neoadjuvant radiotherapy and chemotherapy for rectal cancer.【Methods】A total of 77 patients with stage Ⅱ~Ⅲ rectal cancer in Anzhou District People's Hospital from September 2014 to June 2017 were selected as the subjects of study.All patients received preoperative neoadjuvant radiotherapy and chemotherapy before surgery.Before and after the treatment,the patients were examined quantitatively by ultrasound elastography and contrast-enhanced ultrasound.The changes of ultrasound parameters before and after the treatment and the consistency of T and N stages with pathology after the operation were observed.【Results】 After treatment,the ADT,UES and ESR levels of all patients were significantly lower than those before treatment (P<0.05).After treatment,the scores of RI,AUC,PSV and AUC were lower than those before treatment,and the differences were statistically significant (P<0.05).After neoadjuvant therapy,the results of T-staging assessed by ultrasound were in good agreement with those of pathological examination (P<0.05),and the accuracy was 80.82%.After neoadjuvant therapy,the results of N-staging assessed by ultrasonography were in good agreement with those of pathological examination (P<0.05),and the accuracy was 82.19%.【Conclusion】The contrast-enhanced ultrasound and ultrasound elastography can better reflect the preoperative neoadjuvant treatment effect of rectal cancer,which is conducive to the determination of preoperative staging and guidance of individualized treatment.

关 键 词：直肠肿瘤/治疗 治疗结果 超声检查 多普勒 彩色 

分 类 号：R735.37[医药卫生—肿瘤]