70例鼻咽癌颈部淋巴结转移灶放疗前、后超声影像学的临床应用价值

目的探讨鼻咽癌颈部淋巴结(CLN)转移病灶放疗前、后超声影像学特征的改变对放疗疗效的判定价值。方法回顾性分析该院2008年1月至2010年6月放射治疗前、后3个月内,有3次以上完整超声影像检查记录,经鼻咽部病灶组织病理检查确诊的70例鼻咽癌患者的临床资料。结果 CLN转移病灶以Ⅱ、Ⅲ区多见。放疗前:CLN病灶大,趋于圆形,长径(L)与短径(S)之比(L/S)为1.74±0.59;63.7%淋巴门消失或显著偏移;93.8%病灶血流为Ⅱ、Ⅲ级,血流阻力指数(RI)为0.74±0.09,95.6%病灶血流为周边型和混合紊乱型。放疗后:72.6%病灶消失;残留CLN病灶L/S为1.46±0.53;90.3%病灶血流为0、Ⅰ级;全部残留病灶淋巴门消失或不清。结论超声影像学评价鼻咽癌的CLN转移病灶放疗近期疗效、判定预后具有重要的临床价值。

Clinical application value of ultrasonic imageology before and after radiotherapy in 70 cases of nasopharyngeal carcinoma complicating cervical lymph nodes metastasis

Objective To study the changes of ultrasonographic characteristics before and after radiotherapy in nasopharyngeal carcinoma cervical lymph nodes(CLN)metastatic lesions and to discuss their value on radiotherapy efficacy′s judgment.Methods The clinical data in 70 patients with pathologically diagnosed nasopharyngeal carcinoma before and after 3 months of radiotherapy in our hospital from January 2008 to June 2010,including more than 3 times of full records of ultrasonographic examinations,were performed the retrospectively analysis.Results CLN metastatic lesions were commonly happened in area Ⅱ or area Ⅲ.Before radiotherapy,metastatic lesions were big and tend to be round,L/S:1.74±0.59;63.7% nodal hilus was disappeared or migrated considerably,93.8% metastatic lesions had grade Ⅱ or grade Ⅲ blood flow,RI:0.74±0.09,95.6% metastatic lesions had the peripheral type or mixed disorder type blood flow.After radiotherapy,72.6% metastatic lesions were disappeared;residual CLN metastatic lesions L/S:1.46±0.53;90.3% metastatic lesions had grade 0 or Ⅰ blood flow;the nodal hilus of all residual metastatic lesions disappeared or blurred.Conclusion The ultrasonic imageologic evaluation has the important clinical value on short term radiotherapeutic efficacy and the prognostic judgment of nasopharyngeal carcinoma CLN metastatic lesions.