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目的探讨三维能量多普勒超声在宫颈癌新辅助化疗疗效评估中的应用价值。方法对25例接受新辅助化疗的宫颈癌患者于化疗前及化疗结束后2周行三维能量多普勒超声检查,应用VOCAL功能计算病灶体积,采用血管形成指数(VI)、血流指数(FI)、血管血流指数(VFI)评估病灶在化疗前及化疗后的血流灌注情况,随机收集35例正常人宫颈作为对照组,比较宫颈癌新辅助化疗前后三维能量多普勒超声检查结果的差异。结果 25例宫颈癌患者在新辅助化疗前后和35例正常人宫颈的血流参数比较差异有统计学意义(P<0.05)。25例宫颈癌患者中,19例新辅助化疗有效,其中2例病灶消失,17例病灶体积较化疗前变小;6例化疗无效,其中病灶无变化3例,病灶增大3例。化疗有效组的化疗后VI、FI、VFI较化疗前变小(P<0.05);化疗无效组的化疗后VI、FI、VFI较化疗前无变化(P>0.05)。结论应用三维能量多普勒超声技术检测宫颈癌化疗前后肿瘤血流灌注的变化可反映化疗疗效,为临床优化宫颈癌患者的个体化的治疗方案提供参考意见。
Objective To investigate the value of three-dimensional energy Doppler ultrasound in assessing the efficacy of neoadjuvant chemotherapy for cervical cancer. Methods Twenty-five patients with cervical cancer receiving neoadjuvant chemotherapy underwent three-dimensional Doppler echocardiography before chemotherapy and two weeks after the end of chemotherapy. VOCAL function was used to calculate the volume of the lesion. Vascular formation index (VI), blood flow index (FI) ), Vascular perfusion index (VFI) to assess the perfusion of the lesion before and after chemotherapy, 35 normal human cervical were randomly selected as the control group, compared with three-dimensional energy Doppler ultrasound before and after neoadjuvant chemotherapy for cervical cancer difference. Results There were significant differences in blood flow parameters between 25 cases of cervical cancer before neoadjuvant chemotherapy and 35 cases of normal human cervix (P <0.05). Of 25 cervical cancer patients, 19 cases were neoadjuvant chemotherapy, 2 cases disappeared, 17 cases lesion volume smaller than before chemotherapy; 6 cases of chemotherapy was ineffective, including 3 cases of no change in lesions and 3 cases of lesions increased. The levels of VI, FI and VFI in the chemotherapy-effective group were smaller than those before chemotherapy (P <0.05). The levels of VI, FI and VFI in the chemotherapy-ineffective group were not changed before chemotherapy (P> 0.05). Conclusion The application of three-dimensional energy Doppler ultrasound in detecting the changes of tumor blood flow before and after chemotherapy can reflect the curative effect of chemotherapy and provide reference for the individual treatment of cervical cancer patients.