乳腺超声造影、彩色多普勒超声及磁共振灌注成像在评估乳腺癌新辅助化疗疗效中的对比研究  

Contrast-enhanced Ultrasound,Color Doppler Ultrasound and MRI-PWI for Evaluating the Response of Breast Cancer to Neoadjuvant Chemotherapy

作　　者：张林[1] 郝洁[1] 王立平[2] 沈文状[1] 王单[1] 杨亚龙[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院乳腺甲状腺外科,武汉430030 [2]华中科技大学同济医学院附属同济医院超声影像科,武汉430030

出　　处：《华中科技大学学报（医学版）》2014年第4期449-452,共4页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

摘　　要：目的探讨超声造影技术在乳腺癌新辅助化疗疗效评估中的应用价值,对比其和彩色多普勒超声(彩超)及磁共振灌注成像在疗效评价中的表现。方法收集2011年11月至2013年3月于华中科技大学同济医学院附属同济医院行新辅助化疗并手术治疗的乳腺癌病例27例。分别于第1次化疗前及手术前行乳腺彩色多普勒超声及超声造影检查,同时对其中13例患者于第1次化疗前及手术前行乳腺磁共振灌注成像检查。结果以术后病理反应分级为基准,彩超对新辅助化疗疗效评价的准确性低于超声造影检查。超声造影与磁共振灌注成像在评价疗效方面各有优势。超声造影所测癌灶直径较彩超大,治疗后能通过时间-强度曲线反映血流灌注水平的降低,其中峰值强度和曲线下面积的减少两组差异有统计学意义(P<0.05或P<0.01)。结论超声造影技术对乳腺癌新辅助化疗疗效的评估效果优于彩超,和磁共振灌注成像相比各有优势。超声造影能体现新辅助化疗的效果,其参数可能对疗效的预测有一定价值。Objective To investigate the application value of contrast-enhanced ultrasound（CEU）in assessing the response of breast cancer to neoadjuvant chemotherapy（NAC）and to compare CEU with color doppler ultrasound and magnetic resonance perfusion-weighted imaging（MRI-PWI）in the evaluation of treatment efficacy.Methods This study included 27 breast cancer patients who received NAC and surgical treatment between November 2011 and March 2013 in Tongji Hospital,Wuhan,China.They all underwent color doppler ultrasound and CEU before and after NAC.Among them,thirteen patients were subjected to MRI-PWI.Results In terms of the pathologic response grade,CEU had better performance in evaluating the response of NAC than color doppler ultrasound.CEU and MRI-PWI had their own advantages in evaluation of treatment efficacy.The tumor size measured by CEU was larger than by color doppler ultrasound.After NAC,the reduction of tumor＇s blood perfusion could be reflected on the time-intensity curve.There was signifciant difference in the decrease of the peak intensity（PI）and area under curve（AUC）between CEU and color doppler ultrasound（P〈0.05 or P〈0.01）.Conclusion CEU is superior to color doppler ultrasound in evaluating the response of NAC.Compare with MRI-PWI,CEU has its own advantages.It can reflect the effect of NAC,and its parameters are of value in predicting the response of NAC.

关 键 词：乳腺肿瘤 新辅助化疗 超声造影 磁共振灌注成像 

分 类 号：R737.9[医药卫生—肿瘤]