速度向量成像技术评价头颈部恶性肿瘤患者放化疗前后颈动脉壁运动的初步研究

Assessment of common carotid arterial wall movement by velocity vector imaging in patient with head and neck malignancy after chemoradiotherapy

目的利用速度向量成像（VVI）技术定量评价头颈部恶性肿瘤患者治疗前及放化疗后不同时间段颈总动脉壁运动力学的改变及意义。方法40例头颈部恶性肿瘤患者分别在治疗前、放化疗后1周、3个月、6个月、12个月均进行常规超声及VVI超声检查，比较各个时间段的观察指标：颈总动脉内一中膜厚度（IMT）、内径（D）、收缩期血流峰值（PSV）、阻力指数（RI），以及VVl各项指标：收缩期最大径向运动速度（Vmax）、最大切向应变（Smax）、最大切向应变率（SRmax）、速度达峰时间（Vttp）。结果40例患者常规超声测量数值中，除放化疗后12个月颈动脉IMT与其他时段有差异外（P〈O05），其余各项参数在治疗前和放化疗后不同时段均无统计学差异（均P〈O．05）。VVl测量指标中，治疗前颈总动脉前壁、前外侧壁、后外侧壁Vmax大于后壁、后内侧壁、前内侧壁，放化疗后各阶段前外侧壁、后外侧壁Vmax大于其他各壁（均P〈O05）。治疗前Vmax、Smax、SRmax、Vttp与放化疗后不同时间段比较均有统计学差异（均P〈O05），治疗前各指标均大于放化疗后不同时段相对应指标，放化疗后各时段相对应指标间比较均无统计学差异（均P〉0．05）。结论VVl技术能早期定量地评价头颈部恶性肿瘤患者放化疗后颈动脉壁运动力学的变化。

Objective To quantitatively assess the motion of common carotid artery wall by velocity vector imaging （VVI） in patient with head and neck malignancies after chemoradiotherapy （CRT）. Methods Forty patients with head and neck malig- nancies undergoing CRT were recruited in this study, The carotid ultrasound examinations were undertaken before and lw, 3m, 6m, 12m after treatment. The conventional ultrasound and VVI parameters, including internal-media thickness （IMT）, peak systolic velocity （PSV）, resistance index （RI） and maximal velocity （Vmax）, maximal strain （Smax）, maximal strain rate （SRmax） and time to the peak of velocity （VTTP） were measured. Results Compared to the baseline measurements, there were no significant differ- ences in conventional ultrasound parameters（P 〉0.05）, except the increase of IMT by 12m after CRT （P〈O.05）. Before treatment the Vmax of anterior wall, anterolateral wall and posterolateral wall were higher than that of posterior wall, posteromedial wall and anteromedial wall （P〈O.05）. After treatment the Vmax of anterolateral wall and posterolateral wall were higher than that of other segments （P〈O.05）. Compared with baseline, all values of Vmax, Smax, SRmax and Vttp were significantly decreased after CRT （P〈O.05）; however, there was no significant difference in these parameters among different post-CRT time points （P 〉0.05）. Conclusion The changes of common carotid artery wall motion can be detected by velocity vector imaging in patient with head and neck malignancy at early stages after chemoradiotherapy.