应变率成像技术评价胸部放疗部位与心脏早期损伤的关系

The relationship between thoracic radiotherapy location and early myocardial damage evaluated by strain rate imaging

目的采用应变率成像技术(SRI)分析胸部放疗部位与心脏早期损伤的关系,评价其在心脏损伤方面的临床应用价值。方法60例接受胸部放疗的肿瘤患者分为A组(经前胸照射)和B组(经前胸、后背对穿照射)。放疗前后对两组分别进行常规超声心动图测量和SRI参数测定。结果放疗后与放疗前比较,A组左心室前壁、前间隔的收缩期最大应变率(SRs)、舒张早期最大应变率(SRe)明显减低(P<0.01);B组左心室前壁、前间隔、后壁的SRs、SRe减低(P<0.05);A组、B组左室舒张功能(E/A)减低(P<0.01);放疗后A组左心室前壁、前间隔的SRs、SRe较B组减低(P<0.05),B组后壁的SRs、SRe较A组明显减低(P<0.01)。结论放射线直接照射部位心肌功能较易受到损伤,应变率成像技术可定量分析胸部放疗患者心脏的早期损伤。

Objective To evaluate the clinical value of strain rate imaging （SRI） in detecting the relationship between thoracic radiotherapy location and early myocardial damage. Methods Sixty tumor patients accepted thoracic radiotherapy were enrolled in this study, then they were divided into two groups： A （irradiated from prothorax） and B （irradiated from prothorax and metathorax）. SRI and conventional echocardiographic parameters were detected before and after the radiation treatment. Results The results after radiation was compared with that before radiation treatment, SRs, SRe of group B in anterior wall, anterior septum, posterior wall were significantly lower than those of group A（ P 〈 0.05） ; SRs, SRe of group A in anterior wall, anterior septum were significantly lower than those of group B before the radiation treatment （P 〈 0.01 ）; After the radiation treatment, SRs, SRe of group A in inferior wall, anterior septum were lower than those of group B （ P 〈 0. 05）, and SIRs, SRe of group B in posterior wall were significantly lower than those of group A （ P 〈 0. 01 ）. Conclusion The irradiated myocardium is more easily damaged, and SRI is a non - invasive and valuable method to quantitatively analyze myocardial damage in patients with thoracic radiotherapy.