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目的在鼻咽癌放疗前后应用彩色多普勒超声监测颈部转移淋巴结二维灰阶声像和血供变化及MRI跟踪鼻咽部肿瘤消退程度的相关性研究,为放疗补量提供依据。方法对48例鼻咽癌伴颈部淋巴结转移患者采用放射治疗,在放疗前、放疗后(65 Gy时)应用彩色多普勒超声检测颈部转移淋巴结血供情况与MRI检测鼻咽部肿瘤的消退程度。结果48例鼻咽癌颈部淋巴结转移患者放疗前转移淋巴结血流强度以2~3级为主;放疗后血流强度以0~1级为主,有显著差异(P<0.05)。放疗前,收缩期峰值流速(SPV)20.63±9.36 cm/s,阻力指数(RI)0.59±0.08;放疗后SPV 13.88±9.60 cm/s,RI 0.73±0.14,有显著差异(P<0.05)。淋巴结的血供情况及消退程度与鼻咽部肿瘤的消退呈正相关。结论鼻咽癌放疗前、后应用彩色多普勒超声监测颈部转移淋巴结的血供情况、大小变化,可初步判断放疗效果和作为增加放疗剂量依据之一。
Objective To study the relationship between two-dimensional gray scale acoustic imaging and blood supply changes of cervical lymph node and the follow-up of MRI to detect nasopharyngeal tumor by color Doppler ultrasound before and after radiotherapy of nasopharyngeal carcinoma, so as to provide the basis for radiotherapy. Methods Radiotherapy was performed on 48 patients with nasopharyngeal carcinoma and cervical lymph node metastasis. Before radiotherapy and after radiotherapy (at 65 Gy), color Doppler echocardiography was used to detect the blood supply of cervical metastatic lymph nodes and MRI to detect nasopharyngeal neoplasms Degree of regression. Results 48 patients with cervical lymph node metastasis of nasopharyngeal carcinoma before radiotherapy metastasis lymph node blood flow intensity to 2 to 3 mainly; after radiotherapy intensity of blood flow to 0 to 1 grade, there was significant difference (P <0.05). Before radiotherapy, the systolic peak velocity (SPV) was 20.63 ± 9.36 cm / s and the resistance index (RI) was 0.59 ± 0.08. The SPV after radiotherapy was 13.88 ± 9.60 cm / s and RI was 0.73 ± 0.14, which was significantly different (P <0.05). Lymphatic blood supply and extent of regression and nasopharyngeal tumor regression was positively correlated. Conclusion Nasopharyngeal carcinoma before and after radiotherapy with color Doppler ultrasound monitoring of cervical lymph node metastasis of blood supply, the size of the change can be initially judged radiotherapy and radiation dose as one of the basis to increase.