Mohammadkarim Alireza, Mokhtari-Dizaji Manijhe, Kazemian Ali, Saberi Hazhir
Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Radiation Oncology Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
Ultrasonography. 2018 Jan;37(1):43-49. doi: 10.14366/usg.17016. Epub 2017 Apr 14.
The aim of this study was to assess vascular changes and blood flow abnormalities in the common carotid arteries of patients with head and neck cancers after external radiotherapy, using color Doppler ultrasonography.
We studied 24 patients treated with external radiotherapy for various head and neck cancers. In order to study the acute effects of irradiation on common carotid blood flow and arterial diameter changes, color Doppler ultrasonography parameters such as peak systolic velocity, end diastolic velocity, mean velocity, systolic-to-diastolic velocity (S/D) ratio, pulsatility index (PI), resistive index (RI), and instantaneous diameter changes were evaluated before and after external radiotherapy. Additionally, the blood volume flow (VF) values in the peak systolic and end diastolic phases, as well as mean velocity, were evaluated throughout three cardiac cycles using B-mode ultrasonic image processing.
The findings showed significant changes in the S/D ratio, PI, and RI of the common carotid arteries before and after external radiotherapy (P<0.05). Moreover, a significant decrease in artery diameter and blood VF was observed after radiotherapy relative to the pretreatment values. A significant correlation was found between the blood VF values estimated using ultrasonic measurements and mathematical methods throughout three cardiac cycles.
The hemodynamic parameters of the common carotid arteries changed during radiotherapy. These arterial changes may lead to late adverse effects of radiotherapy, such as ischemic strokes and ischemic attacks.
本研究旨在使用彩色多普勒超声评估头颈部癌症患者接受体外放疗后颈总动脉的血管变化和血流异常情况。
我们研究了24例接受体外放疗治疗各种头颈部癌症的患者。为了研究放疗对颈总动脉血流和动脉直径变化的急性影响,在体外放疗前后评估了彩色多普勒超声参数,如收缩期峰值速度、舒张末期速度、平均速度、收缩期与舒张期速度(S/D)比值、搏动指数(PI)、阻力指数(RI)以及瞬时直径变化。此外,使用B模式超声图像处理在三个心动周期内评估收缩期峰值和舒张末期的血容量流量(VF)值以及平均速度。
研究结果显示,体外放疗前后颈总动脉的S/D比值、PI和RI有显著变化(P<0.05)。此外,放疗后相对于治疗前值,观察到动脉直径和血VF显著降低。在三个心动周期内,使用超声测量和数学方法估计的血VF值之间存在显著相关性。
放疗期间颈总动脉的血流动力学参数发生了变化。这些动脉变化可能导致放疗的晚期不良反应,如缺血性中风和缺血性发作。