彩超测量肺动脉血流加速时间对放射性肺损伤的预测价值

THE VALUE OF THE PULMONARY ARTERIAL FLOW ACCELERATION TIME BY THE COLOR DOPPLER ULTRASOUND ON PREDICTING RADIATION LUNG INJURY

目的探讨放疗前彩超测量肺动脉血流加速时间(AT)在预测≥2级放射性肺损伤中的应用价值。方法自2013年6月—2015年1月,共纳入81例肺癌放疗患者,在放疗前对所有患者均行彩超检查,测量AT。根据放疗后随访结果,将病例分为发生≥2级放射性肺损伤组和未发生组,将二组放疗前测得的AT进行对比研究,通过ROC曲线探讨AT对于预测≥2级放射性肺损伤发生的准确性,并确定最佳cutoff值。结果 81例肺癌患者中有18例发生了≥2级放射性肺损伤。发生放射性肺损伤组的AT为(105.7±17.4)ms,未发生放射性肺损伤组的AT为(124.8±14.4)ms,二者差异有统计学意义(P<0.05)。ROC曲线下面积为0.821,确定最佳cutoff值为113ms,以AT<113ms为标准来预测≥2级放射性肺损伤的发生,其敏感性、特异性和准确性分别为81.6%、85.7%和82.5%。结论放疗前彩超测量肺动脉血流加速时间可以预测≥2级放射性肺损伤的发生,对临床有一定的指导作用。

Objective To investigate the value of the pulmonary arterial flow acceleration time（AT）which was measured by the color Doppler ultrasound in predicting grade≥2 radiation lung injury.Methods Between June 2013 and January 2015,63 patients with lung cancer receiving radiotherapy in our hospital were included.Before radiotherapy,all patients were checked by color Doppler utrasound and AT were measured.According to the follow-up results the patients were divided into groups：developed and not developed grade ≥2 radiation induced lung injury groups,the AT of the two groups were compared.ROC curves were used to examine the diagnostic value of AT and determine the best cutoff value.Results Grade≥2 radiation lung injury occuerred in14 patients with lung cancer.The AT of developed radiation lung injury group was 105.7±17.4ms,and the AT of not developed radiation lung injury group was 124.8±14.4ms,the difference was statistically significant（P〈0.05）.The sensitivity,specificity and accuracy of using AT113ms to predict grade ≥2 radiation lung injury was 81.6%,85.7% and 82.5% respectively.Conclusion The AT which is measured by the color Doppler ultrasound can predict the development of grade≥2 radiation lung injury,and can guide the treatment role in clinical in some way.