超声诊断放射性颈动脉狭窄1例并文献复习  

Ultrasonopraphic diagnosis of radiation-induced carotid artery stenosis:A case report and literature review

作　　者：张嘉靖 曹文悦 陈洁[1] ZHANG Jiajing;CAO Wenyue;CHEN Jie(Shanghai Chest Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China)

机构地区：[1]上海市胸科医院,上海交通大学医学院附属胸科医院超声科,上海200030

出　　处：《临床与病理杂志》2024年第10期1470-1474,共5页Journal of Clinical and Pathological Research

摘　　要：长期放射治疗(以下简称“放疗”)引起的颈动脉狭窄可引发卒中,进而导致患者死亡。本文对1例胸腺恶性肿瘤放疗后患者的颈动脉进行彩色多普勒超声随访检查,随访时间为放疗后1周、1年、2年、3年、颈动脉血管成形术和椎动脉支架植入术后5个月。超声检查记录内容包括颈动脉平均内-中膜厚度(intima-media thickness,IMT)、狭窄分布范围、狭窄程度及斑块的超声特征。结果显示放疗后3年患者左侧颈总动脉、左侧锁骨上动脉、左侧椎动脉内均见以非钙化斑块为主的软斑块,狭窄程度均在中度以上。随着放疗时间延长,颈动脉平均IMT持续增厚。因此,对长期放疗患者进行定期颈动脉超声检查是否有助于早期干预这种并发症,提高患者的生存率和生活质量是我们需要研究和探索的问题。Carotid artery stenosis induced by long-term radiotherapy can lead to stroke and subsequent patient mortality.This report presents a color Doppler ultrasonography follow-up of the carotid arteries in a patient who underwent radiotherapy for a malignant thymic tumor.Follow-up examinations were performed at 1 week,1 year,2 years,and 3 years after radiotherapy,and at 5 months after carotid angioplasty and vertebral artery stenting.The ultrasonographic evaluation recorded the average carotid intima-media thickness(IMT),the distribution and degree of stenosis,and the sonographic characteristics of plaques.Results showed that,3 years post-radiotherapy,soft plaques predominantly composed of non-calcified material were observed in the left common carotid artery,left subclavian artery,and left vertebral artery,with the degree of stenosis being moderate or greater.Additionally,the average carotid IMT continuously increased with longer durations following radiotherapy.These findings suggest that regular carotid ultrasonography in patients undergoing long-term radiotherapy may facilitate early intervention for this complication,thereby improving patient survival and quality of life.

关 键 词：颈动脉狭窄 放射治疗 超声成像 肿瘤 斑块 

分 类 号：R73[医药卫生—肿瘤]