乳腺癌新辅助化疗后早期扩散加权成像参数的变化与化疗效果的关系  

Early change of MR diffusion weighted imaging parameters of breast cancer after neoadjuvant chemotherapy and the relationship of the change with therapy response

作　　者：姜原[1] 方艳[1] 王霄英[1] 杨馨[1] 郭丽[1] 秦乃姗[1] 

机构地区：[1]北京大学第一医院医学影像科,100034

出　　处：《中华放射学杂志》2017年第3期166-169,共4页Chinese Journal of Radiology

摘　　要：目的 探讨乳腺癌新辅助化疗（NAC）后早期DWI参数的变化及其与NAC最终疗效的关系.方法 前瞻性收集经粗针穿刺确诊拟接受NAC的局部进展期乳腺癌患者,行NAC前乳腺DWI检查及NAC第1周期完成后24 h DWI复查,并在NAC所有周期完成后获得手术病理结果.14例患者（15个病灶）纳入研究.记录NAC前、后病灶最小ADC值,并计算最小ADC值变化率.NAC所有周期完成后2周,根据临床疗效评估结果将患者分为临床完全缓解（cCR）和非cCR组;根据病理疗效评估结果,分为病理完全缓解（pCR）和非pCR组.采用配对t检验比较NAC前、后病灶最小ADC值的差异,采用Mann-Whitney U检验比较cCR与非cCR组间、pCR与非pCR组间最小ADC值及其变化率的差异.结果 15个病灶组织类型均为浸润性导管癌.临床疗效评估,cCR 5个、非cCR 10个;病理疗效评估,pCR 6个,非pCR 9个.NAC前、后的病灶的最小ADC值分别为（0.78±0.15）×10^-3和（0.91±0.16）×10^-3mm^2/s,差异有统计学意义（t=-2.954,P=0.010）.cCR与非cCR组间、pCR与非pCR组间的最小ADC值及其变化率差异均无统计学意义（P均〉0.05）.结论 乳腺癌NAC后24 h,病灶的最小ADC值即出现升高,但与最终化疗疗效无明显相关.Objective To investigate the early change of MR DWI parameters of breast cancer after neoadjuvant chemotherapy （NAC） and assess the relationship between the changes of the NAC response. Methods Patients with local advanced breast cancer diagnosed by biopsy were enrolled in the prospective study. They received DWI examination before NAC and then received DWI examination at 24 h after the first cycle of NAC. The pathological results of breast cancers were recorded after NAC finished. 14 patients （15 lesions） were enrolled in this study.The minimum ADC values of breast cancer before NAC and after the first cycle of NAC were recorded, and their change rates were calculated. Two weeks after NAC,all cases were divided into clinical complete response （cCR） and non-clinical complete response group according to clinical NAC response evaluation. Then lesions were divided into pathological complete response （pCR） and non-pathological complete response group according to pathological NAC response evaluation. Using the Paired samples t test,we analysed the change of ADC values 24 h after the first cycle of NAC. The ADC values and change rates were compared between cCR and non-cCR group using Mann-Whitney U test. The ADC values and change rates were also compared between pCR and non-pCR group using Mann-Whitney U test.Results The 15 cases were all invasive ductal carcinoma patients. According to clinical NAC response evaluation, 5 cases were cCR and 10 cases were non-cCR. According to pathological NAC response evaluation, 6 cases were pCR and 9 cases were non-pCR. Before NAC, the minimum ADC value of breast cancer was（0.78±0.15）×10^-3 mm^2/s. After the first cycle of NAC, the minimum ADC value of breast cancer was（0.91 ± 0.16） × 10^-3 mm^2/s. The minimum ADC value of breast cancer significantly increased 24 h after the first cycle of NAC （t=-2.954,P=0.010）. But ADC value and its change rate were not significantly different between cCR and non-cCR groups, also between pCR and non-pCR groups （P�

关 键 词：乳腺肿瘤 磁共振成像 治疗结果 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]