磁共振扩散加权成像ADC值对局部进展期乳腺癌新辅助化疗疗效及病理反应性的评估价值  

Clinical evaluation of significance of ADC in diffusion-weighted MR imaging for locally advanced breast cancer after neo-adjuvant chemotherapy and its correlation with pathological response

作　　者：沈璐[1] 唐菲[1] 林翌[1] 周洁[1] 王轶彬[1] 宗根林[1] 张蕾[1] 

机构地区：[1]同济大学附属东方医院医学影像科,上海200120

出　　处：《临床和实验医学杂志》2017年第7期717-720,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨磁共振扩散加权成像(DWI)的表观扩散系数(ADC)值对局部进展期乳腺癌新辅助化疗(NAC)疗效及病理反应性的评估价值。方法对108例局部进展期乳腺癌患者术前进行4个周期的NAC治疗,分别于化疗前、化疗结束后进行DWI检查,测量病灶ADC值;根据临床疗效及病理反应性分级分为完全缓解(CR)+部分缓解(PR)组和疾病稳定(SD)+疾病进展(PD)组;组织学显著反应(MHR)组和组织学非显著反应(NMHR)组,比较两组间ADC值变化及与病理反应性结果的相关性。结果化疗后,CR+PR组的ADC值明显升高,且显著高于SD+PD组(P<0.05);化疗后的肿瘤体积变化与化疗前ADC值呈显著负相关,与ΔADC呈显著正相关(r=-0.463,0.539,P<0.05);化疗后,MHR组和NMHR组患者的ADC值均明显升高,但MHR组ADC值、ΔADC均显著高于NMHR组(P<0.05)。结论 DWI的ADC值对局部进展期乳腺癌NAC化疗早期疗效及病理反应改变具有较好的评估价值。Objective To explore the clinical effect of apparent diffusion coefficient（ADC） value of diffusion-weighted MR imaging（DWI） for detection of local advanced breast cancer after neoadjuvant chemotherapy and its correlation with pathological response. Methods 108 patients with local advanced breast cancer were given with neoadjuvant chemotherapy（NAC） for 4 courses before surgery,and DWI was performed before and after NAC to measure the ADC value of lesions. According to the clinical effect and pathological response,all these patients were divided into CR ＋ PR and SD ＋ PD groups,MHR and NMHR groups. The changes in ADC values and correlation with results of pathological response were compared between these two groups. Results After chemotherapy,the ADC value in CR ＋ PR group was obviously increased,and significantly higher than that of SD ＋ PD group（P〈0.05）. The volume of tumor after chemotherapy was negative correlated with ADC value before chemotherapy,and positively correlated with ΔADC（r =-0.463,0.463,P〈0.05）. After chemotherapy,the values of ADC in MHR and NMHR groups,and the values of ADC and Δ ADC in MHR group were significantly higher than those of NMHR group（P〈0.05）. Conclusion The ADC value of DWI has important significance in evaluation of early curative effect of NAC and change of pathological response in patients with locally advanced breast cancer.

关 键 词：局部进展性乳腺癌 磁共振扩散加权成像 表观扩散系数 新辅助化疗 病理反应性 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]