简易肺部超声评分法对乳腺癌术后放疗后放射性肺损伤的评估  

Evaluation of Radiation-Induced Lung Injury After Postoperative Radiotherapy in Breast Cancer Patients Using a Simplified Lung Ultrasound Scoring Method

作　　者：张伟[1] 夏祯 尹克杰 刘尧赫 黄骁辰 缪青 Zhang Wei;Xia Zhen;Yin Kejie;Liu Yaohe;Huang Xiaochen;Miao Qing(Department of Ultrasound,The Affiliated Cancer Hospital of Nanjing Medical University,Nanjing,Jiangsu 210009,China;Department of Radiology,Drum Tower Hospital Affiliated to Nanjing University Medical School,Nanjing,Jiangsu 210008,China;Department of Medical Equipment,The Affiliated Cancer Hospital of Nanjing Medical University,Nanjing,Jiangsu 210009,China;Department of Pathology,The Affiliated Cancer Hospital of Nanjing Medical University,Nanjing,Jiangsu 210009,China)

机构地区：[1]南京医科大学附属肿瘤医院超声科,南京市210009 [2]南京大学医学院附属鼓楼医院医学影像科,南京市210008 [3]南京医科大学附属肿瘤医院医学装备部,南京市210009 [4]南京医科大学附属肿瘤医院病理科,南京市210009

出　　处：《中国超声医学杂志》2024年第8期875-879,共5页Chinese Journal of Ultrasound in Medicine

基　　金：江苏省肿瘤医院基金项目(No.ZL202217)。

摘　　要：目的 本研究旨在评估简易超声肺部评分法在乳腺癌术后放疗后放射性肺损伤(RILI)中的有效性。方法 研究共纳入67例单侧乳腺癌术后放疗后患者。通过两胸八分区简易经胸肺部超声评分法对患侧及健侧肺部情况进行探查,分别记录各个分区的B线、胸膜和并发症情况并评分,相加得到简易肺部超声评分,分析放疗剂量及放疗时间对评分的影响,以高分辨率CT为标准,评估简易肺部超声评分法对RILI的诊断价值。结果 患侧简易肺部超声评分显著高于健侧,胸膜评分与B线评分呈正相关,并发症评分与放疗时间和胸膜评分呈正相关。简易肺部超声评分法评估中-重度肺间质损伤的受试者工作特征(ROC)曲线下面积(AUC)为0.867。结论 简易肺部超声评分法能快速有效识别乳腺癌术后放疗导致的中至重度RILI,有望成为评估RILI严重程度的影像学指标。Objective This study aims to evaluate the effectiveness of a simplified lung ultrasound scoring system in assessing radiation-induced lung injury(RILI)after postoperative radiotherapy in breast cancer patients.Methods The study included 67 patients with unilateral breast cancer who underwent postoperative radiotherapy.A simplified eight-zone transthoracic lung ultrasound scoring method was used to examine and score the conditions of B-lines,pleura,and complications in both the treated and healthy sides of the lungs.The scores were then summed up to obtain a simplified lung ultrasound score.The impact of radiotherapy dose and duration on the scores was analyzed.High-resolution CT scans served as the standard for assessing the value of the simplified lung ultrasound scoring method in evaluating the severity of RILI.Results The simplified lung ultrasound scores on the treated side were significantly higher than those on the healthy side.There was a positive correlation between pleural scores and B-line scores,and complication scores were positively correlated with both radiotherapy duration and pleural scores.The area under the receiver operating characteristic(ROC)curve for assessing moderate to severe interstitial lung damage using the simplified lung ultrasound scoring method was 0.867.Conclusions The simplified lung ultrasound scoring system can quickly and effectively identify patients with moderate to severe RILI after postoperative radiotherapy for breast cancer.This method has the potential to become an imaging marker for evaluating the severity of RILI.

关 键 词：肺部超声 放射性肺损伤 量化评分 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]