三维斑点追踪成像(3D-STI)在评价乳腺癌患者化疗后早期右室心肌力学特性的临床应用价值  

Clinical application of three-dimensional spot tracking imaging(3D-STI)in evaluating the early right ventricular myocardial mechanical properties after chemotherapy for breast cancer

作　　者：魏玉秀 张萌 齐伟 WEI Yu-xiu;ZHANG Meng;QI Wei(Department of Ultrasonic Diagnosis and Treatment Center,Xi'an International Medical Center Hospital;Department of Ultrasound Diagnosis,the Hospital of Xidian University,Xi'an 710071,Shaanxi,China)

机构地区：[1]西安国际医学中心医院超声诊疗中心 [2]西安电子科技大学医院超声诊断科,陕西西安710071

出　　处：《川北医学院学报》2023年第10期1412-1415,共4页Journal of North Sichuan Medical College

摘　　要：目的:探究三维斑点追踪成像(3D-STI)评价乳腺癌患者化疗后早期右室心肌力学特性的临床应用价值。方法:选取102例接受吡柔比星化疗的乳腺癌患者为研究对象,分别于化疗前(T0)、化疗第2周期末(T1)、第6周期末(T2)进行3D-STI检查,化疗期间右心室射血分数(RVEF)<45%或下降10%以上定义为心脏毒性反应(AIC)。比较T0、T1、T2右室3D-STI参数,评估各参数对AIC的预测价值。结果:与T0时相比,T1时RVGAS、RVGLS绝对值均降低(P<0.05),T2时均进一步降低(P<0.05),RVEF在T2时降低(P<0.05);Logistic回归分析显示,T1时RVGAS、RVGLS绝对值均与AIC的发生具有相关性(P<0.05);ROC曲线显示,T1时RVGAS绝对值<27.7%预测化疗结束后出现AIC的敏感度、特异度分别为77.80%、82.90%,对应的曲线下面积(AUC)为0.88,T1时RVGLS绝对值<19.96%预测化疗结束后出现AIC的敏感度、特异度分别为72.20%、88.20%,对应的AUC为0.84。结论:3D-STI参数可反映乳腺癌患者吡柔比星化疗后右室心肌力学早期变化,RVGAS、RVGLS绝对值可在一定程度上预测AIC风险。Objective:To explore the clinical application of three-dimensional speck tracking imaging(3D-STI)in evaluating the early right ventricular myocardial mechanical properties after chemotherapy for breast cancer.Methods:102 patients with breast cancer who received pirarubicin chemotherapy in the hospital were selected as research subjects.3D-STI examination was performed before chemotherapy(T0)and at the end of the 2 cycle of chemotherapy(T1)and the end of the 6 cycle of chemotherapy(T2)respectively,and right ventricular ejection fraction(RVEF)<45% or decreased by more than 10% during chemotherapy was defined as anthracycline-induced cardiotoxicity(AIC).The right ventricular 3D-STI parameters were compared at T0,T1 and T2 and evaluate their predictive value for AIC.Results:Compared with T0,RVGAS and RVGLS were decreased at T1(P<0.05),and were further decreased at T2(P<0.05).RVEF was decreased at T2(P<0.05).Logistics regression analysis showed that RVGAS and RVGLS at T1 were correlated with the occurrence of AIC(P<0.05).ROC curve showed that the sensitivity,specificity and corresponding AUC of RVGAS<27.70% at T1 on predicting the occurrence of AIC after chemotherapy were 77.80%,82.90% and 0.88,respectively.The sensitivity,specificity and AUC of RVGLS<19.96% at T1 on predicting the occurrence of AIC after chemotherapy were 72.20%,88.20% and 0.84.Conclusion:3D-STI parameters can reflect the early changes of right ventricular myocardial mechanics in patients after pyirubicin chemotherapy for breast cancer,and RVGAS and RVGLS can predict AIC risk to a certain extent.

关 键 词：乳腺癌 化疗 吡柔比星 三维斑点追踪成像 右心室功能 

分 类 号：R979.1[医药卫生—药品]