剪切波弹性成像评估鼻咽癌放疗后腮腺损伤  

Assessment of Shear Wave Elastography for Postradiotherapy Parotid Glands Damages in Nasopharyngeal Carcinoma

作　　者：王丹丹 周历安[1] 张建辉 徐金顺 WANG Dandan;ZHOU Lian;ZHANG Jianhui;XU Jinshun(Department of Ultrasound,West China Hospital,Sichuan University,Chengdu 610041,China;不详)

机构地区：[1]海口市人民医院超声科,海南海口570208 [2]四川大学华西医院超声科,四川成都610041

出　　处：《中国医学影像学杂志》2021年第8期781-783,787,共4页Chinese Journal of Medical Imaging

基　　金：国家自然科学基金青年基金(81701797);北京市自然科学基金面上项目(7192200);成都市技术创新研发项目(2019-YF05-00376-SN);四川省卫生健康委员会项目(20PJ011)。

摘　　要：目的探讨剪切波弹性成像(SWE)评估鼻咽癌放疗后腮腺损伤的临床价值。资料与方法选取鼻咽癌放疗后腮腺损伤患者25例,同期选取20例健康志愿者作为对照组,行双侧腮腺SWE检查,测量杨氏模量平均值(Emean),比较两组腮腺Emean的差异;根据放疗后随访时间,将鼻咽癌放疗后腮腺损伤患者分为早期损伤组14例和晚期损伤组11例,比较两组Emean的差异,采用Spearman相关分析腮腺Emean与口干程度的相关性。结果鼻咽癌放疗后腮腺Emean高于正常腮腺[(48.5±24.4)k Pa比(22.5±9.4)k Pa;F=48.890,P<0.01]。放疗后晚期损伤组Emean明显高于放疗后早期损伤组[(63.6±20.4)k Pa比(36.6±20.8)k Pa;F=0.023,P<0.05],放疗后早期损伤组Emean明显高于对照组[(36.6±20.8)k Pa比(24.8±7.3)kPa;F=10.405,P<0.05]。腮腺Emean与口干程度无显著相关性(r=-0.162,P>0.05)。结论SWE可用于评估鼻咽癌放疗后腮腺损伤,鼻咽癌放疗后腮腺硬度较正常腮腺增加,放疗后远期腮腺硬度较早期更大。Purpose To evaluate the clinical assessment value of shear wave elastography(SWE)of postradiotherapy(RT)parotid gland damages in patients with nasopharyngeal carcinoma.Materials and Methods Twenty-five nasopharyngeal carcinoma patients with RT parotid gland damages and 20 matched healthy subjects were included and performed SWE examination.The Young’s modulus value(Emean)were further measured and recorded,comparing the differences of Emean of parotid glands between these two groups.According to RT followup time,all patients were divided into the acute-toxicity group(14 cases)and the late-toxicity group(11 cases),comparing differences in the value of Emean between the groups.The relationship between Emean and degree of xerostomia was evaluated via Spearman correlation analysis.Results Compared with control group,the Emean of RT parotid glands was significantly increased in patients with nasopharyngeal carcinoma[(48.5±24.4)kPa vs.(22.5±9.4)kPa;F=48.890,P<0.01].The mean value of Emean was significantly greater in the late-toxicity group than those in the acute-toxicity[(63.6±20.4)kPa vs.(36.6±20.8)kPa;F=0.023,P<0.05],and the Emean of the acute-toxicity group was significantly greater than those in the control group[(36.6±20.8)k Pa vs.(24.8±7.3)k Pa;F=10.405,P<0.05].There was no significant correlation between degree of xerostomia and Emean value(r=-0.162,P>0.05).Conclusion SWE could be used to assess RT parotid gland damages in patients with nasopharyngeal carcinoma.The stiffness of parotid glands is increased in nasopharyngeal carcinoma patients with RT,with the greater stiffness in the late-toxicity group than the acute-toxicity group.

关 键 词：鼻咽肿瘤 超声检查 弹性成像技术 放射疗法 腮腺 

分 类 号：R739.6[医药卫生—肿瘤] R730.41[医药卫生—临床医学]