摘要
目的探讨彩色多普勒超声在鼻咽癌颈部淋巴结转移的诊断和评价其放射效应中的作用。方法对 19例鼻咽低分化鳞癌伴颈部淋巴结转移的患者 ,在放疗前、中、后进行了多次颈部淋巴结彩色多普勒超声检查 ,重点观察其血供变化情况。结果(1)血供好的淋巴结退缩率高。 (2 )在上颈部淋巴结直径大于 4厘米的患者的中下颈测得多个血流分级III或IV级的直径小于 1厘米的淋巴结 ,放疗 6 0Gy时 ,血流均为II级以下。 (3)颈部淋巴结接受 76～ 80Gy照射后残存的无血流的淋巴结中未见肿瘤细胞。结论 (1)血供是影响放射效应的重要因素。 (2 )彩色多普勒超声可帮助判断是否有触诊未及和CT扫描观察不到的小的颈部淋巴结。建议 :若上颈淋巴结直径大于 4cm ,中下颈剂量应达 6 0Gy为好。 (3)颈部淋巴结接受剂量 70Gy后 ,若淋巴结残存 ,局部补量 6～ 10Gy。
Objective To discuss the effect of color Doppler flowing imaging (CDFI) in the diagnosis and estimating the radiation response of cervical lymph nodes mestastased from nasopharyngeal carcinoma Methods Nineteen metastasic cervical lymph nodes of 19 nasopharyngeal poorly differentiated squamous cell carcinoma patients were studied with CDFI, the blood supply was measured before, during and after irradiation Results (1) The better the supply is, the higher the regression rate is (2) Several nodes, the diameter of which is less than 1cm, were found in the 12 patients whose upper cervical lymph nodes is bigger than 4cm The blood flow is grade I or II when the radiation dose is 60 Gy (3) No cancer cell was found in the no blood flow remaining nodes with total dose of 76～80 Gy Conclusion (1) CDFI can help a doctor to judge if there are little cervical lymph nodes, which often can't be palpated, even observed through CT The author suggests: It's better that the radiation dose of the lower neck is 60 Gy if the diameter of the upper cevical lymph nodes is more than 4 cm (3) When the radiation dose of cervical lymph nodes is 70 Gy, if the lymph nodes remain, the dose of 6～10 Gy should be added
出处
《第一军医大学学报》
CSCD
1999年第6期580-582,共3页
Journal of First Military Medical University
关键词
鼻咽癌
颈部淋巴结转移
放射治疗
彩色多普勒超声
nasopharyngeal carcinoma
metastasic cervical lymph nodes
radiotherapy
Color Doppler Flowing Imaging
