血流向量成像技术评估卵巢癌术后化疗后左心室舒张功能  

Vector flow mapping technique for evaluating left ventricular diastolic function in ovarian cancer patients with postoperative chemotherapy

作　　者：陈春翠 秦文娟 田芮萌 陈若茜 周诣斐 黄磊[1] 郭雪婷 芦桂林 CHEN Chuncui;QIN Wenjuan;TIAN Ruimeng;CHEN Ruoxi;ZHOU Yifei;HUANG Lei;GUO Xueting;LU Guilin(Department of Ultrasound,the First Affiliated Hospital,Shihezi University,Shihezi 832008,China)

机构地区：[1]石河子大学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》2024年第8期477-481,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：兵团指导性科技计划项目(KY000109)。

摘　　要：目的观察血流向量成像(VFM)技术评估卵巢癌(OC)术后化学治疗(简称化疗)后左心室舒张功能改变的价值。方法前瞻性以37例OC术后接受化疗患者为化疗组,以同期40名健康成人为对照组。对化疗组分别于化疗前、化疗3及6个周期后,对照组于入组时行常规超声心动图及VFM检查,比较化疗前组间及化疗组内不同时间点资料,分析化疗组VFM与血红蛋白及常规超声心动图结果的相关性。结果化疗组年龄、体质量、体表面积(BSA),化疗前血红蛋白水平、常规超声心动图及VFM结果与对照组差异均无统计学意义(P均>0.05)。化疗组内,随化疗周期增加,血红蛋白水平渐次降低、等容舒张期(IR)及心房收缩期(AS)左心室内压力差(IVPD)及压力差梯度(IVPG)逐渐增大(校正P均<0.05);而常规超声心动图仅化疗6个周期后左心房容积指数(LAVI)及二尖瓣舒张早期血流峰值速度/二尖瓣环舒张早期平均运动峰值速度(E/e’)较化疗前升高(校正P均<0.05)。化疗组舒张期各时相VFM结果均与血红蛋白水平呈强相关(|r|=0.718~0.836,P均<0.05),与LAVI呈弱至中度相关(|r|=0.375~0.525,P均<0.05),与E/e’呈中度相关(|r|=0.424~0.537,P均<0.05)。结论OC术后化疗早期即可出现左心室舒张功能受损。VFM可较常规超声心动图更敏感地检出左心室舒张早期功能轻微改变。Objective To observe the value of vector flow mapping(VFM)technique for assessing changes of left ventricular diastolic function in ovarian cancer(OC)patients who underwent postoperative chemotherapy.Methods Totally 37 OC patients who received postoperative chemotherapy were prospectively enrolled in chemotherapy group,while 40 healthy adults were taken as controls(control group).Routine echocardiography and VFM were performed for chemotherapy group before chemotherapy,after 3 and 6 cycles of chemotherapy,also for controls at enrollment,and comparison was performed between groups before chemotherapy,as well as among different time points within chemotherapy group,and the correlations of VFM results with hemoglobin and routine echocardiographic results in chemotherapy group were analyzed.Results No significant difference of age,body mass,body surface area(BSA),nor hemoglobin level,routine echocardiographic and VFM results before chemotherapy was found between groups(all P>0.05).With the process of chemotherapy,hemoglobin level gradually decreased,the isovolumic relaxation period(IR),atrial systole period(AS)intraventricular pressure difference(IVPD)and intraventricular pressure gradient(IVPG)of the left ventricle gradually increased(adjusted P<0.05),whereas routine echocardiography only showed that the left atrial volume index(LAVI)and the ratio of early mitral inflow velocity and the mean mitral annular early diastolic velocity(E/e’)increased after 6 cycles of chemotherapy compared with those pre-chemotherapy(adjusted P<0.05).In chemotherapy group,VFM results in all diastolic subphases were strongly correlated with hemoglobin levels(|r|=0.718 to 0.836,all P<0.05),weakly to moderately correlated with LAVI(|r|=0.375 to 0.525,all P<0.05)and moderately correlated with E/e’(|r|=0.424 to 0.537,all P<0.05).Conclusion The diastolic function of left ventricle was probably damaged in early stage after postoperative chemotherapy in OC patients.VFM might detect slight changes of early diastolic function of left ventricle

关 键 词：卵巢肿瘤 药物疗法 联合 超声心动描记术 前瞻性研究 

分 类 号：R737.31[医药卫生—肿瘤] R445.1[医药卫生—临床医学]