三维斑点追踪成像评估化疗致卵巢癌患者左心室功能损伤  

Three-dimensional speckle tracking imaging in evaluation on left ventricular function injuries caused by chemotherapy for ovarian cancer

作　　者：翟子敬 秦文娟[2] 王臻 冯佳 黄磊[2] 董珊珊[2] 张彩云[2] 刘奎灿[2] 芦桂林[2] ZHAI Zijing;QIN Wenjuan;WANG Zhen;FENG Jia;HUANG Lei;DONG Shanshan;ZHANG Caiyun;LIU Kuican;LU Guilin(Department of Clinical Medicine, Shihezi University School of Medicine, Shihezi 832008, China;Department of Ultrasound Medicine, the First Affiliated Hospital, Shihezi University School of Medicine, Shihezi 832008, China)

机构地区：[1]石河子大学医学院临床医学系,新疆石河子832008 [2]石河子大学医学院第一附属医院超声医学科,新疆石河子832008

出　　处：《中国介入影像与治疗学》2021年第4期220-224,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：石河子大学自主资助支持校级科研项目(ZZZC202076A);石河子大学青年创新培育人才项目(CXPY202008);石河子大学医学院第一附属医院院级课题(QN201901、QN201919、QN202019)。

摘　　要：目的观察三维斑点追踪成像(3D-STI)评估紫杉醇联合卡铂对卵巢癌患者左心室功能影响的价值。方法对30例卵巢癌术后接受紫杉醇联合卡铂化学治疗(简称化疗)患者(卵巢癌组)分别于化疗前及化疗3、6周期后行3D-STI检查,以同期30名正常女性为对照组,获取左心室射血分数(LVEF)、左心室整体纵向应变(GLS)、圆周应变(GCS)、左心室扭转角度(LVtw)、扭矩(Tor)及纵向与圆周应变显像舒张指数(L-SI-DI、C-SI-DI),计算心肌综合指数(MCI)。采用受试者工作特征(ROC)曲线评价3D-STI参数对化疗致左心室收缩功能损害的诊断效能。结果卵巢癌组化疗前LVEF、GLS、GCS、LVtw、Tor、MCI、L-SI-DI及C-SI-DI与对照组差异均无统计学意义(P均>0.05),化疗3、6周期后上述参数均较对照组及化疗前降低,且化疗6周期后下降更显著(P均<0.05)。GLS、LVtw、Tor及MCI诊断化疗致左心室收缩功能损伤的AUC均>0.800(P均<0.05),其敏感度、特异度均>60.00%,约登指数均>0.50;其中MCI的AUC最大(0.907),Tor的敏感度最高(86.67%),GLS特异度最高(90.00%)。结论3D-STI可早期发现并量化评价紫杉醇联合卡铂化疗所致卵巢癌患者左心室功能损伤。Objective To explore the value of three-dimensional speckle tracking imaging(3D-STI)for evaluation on left ventricular function injuries caused by paclitaxel combined with carboplatin in patients with ovarian cancer.Methods Totally 30 patients with ovarian cancer who underwent paclitaxel combined with carboplatin chemotherapy after surgical operation were enrolled in ovarian cancer group,while 30 normal subjects were taken as controls(control group).3D-STI examination was performed before chemotherapy and after the third and sixth cycle of chemotherapy,respectively.The left ventricular ejection fraction(LVEF),left ventricular global longitudinal strain(GLS),global circumferential strain(GCS),left ventricular twist angle(LVtw),torque(Tor)and longitudinal and circumferential strain imaging diastolic index(L-SI-DI,C-SI-DI)and myocardial composite index(MCI)were measured or calculated.Receiver operating characteristic(ROC)curve was used to observe the diagnostic efficacy of 3D-STI parameters for chemotherapy-induced left ventricular systolic function injury.Results Before chemotherapy,no significant difference of LVEF,GLS,GCS,LVtw,Tor,MCI,L-SI-DI nor C-SI-DI was found between ovarian cancer group and control group(all P>0.05),whereas the above parameters after the third and sixth cycle chemotherapy in ovarian cancer group were all lower than those of control group and before chemotherapy,especially after the sixth cycle of chemotherapy(all P<0.05).The area under the curve(AUC)of GLS,LVtw,Tor and MCI for diagnosis of chemotherapy-induced left ventricular systolic function injury were all>0.800(all P<0.05),the sensitivities and specificities were all>60.00%,and Youden indexes were all>0.50,among which the AUC of MCI(0.907),the sensitivity of Tor(86.67%),and the specificity of GLS were the highest(90.00%).Conclusion 3D-STI could early detect and quantify left ventricular function injuries in ovarian cancer patients caused by paclitaxel and carboplatin.

关 键 词：卵巢肿瘤 心室功能 左 紫杉醇 卡铂 三维斑点追踪成像 

分 类 号：R737.31[医药卫生—肿瘤] R540.45[医药卫生—临床医学]