超声造影评估乳腺癌新辅助化疗疗效的临床价值  

Evaluation on clinical effect of neoadjuvant chemotherapy for breast cancer by contrast-enhanced ultrasound

作　　者：万财凤[1] 王琳[1] 刘雪松[1] 方华[1] 李凤华[1] 

机构地区：[1]上海交通大学医学院附属仁济医院超声医学科,上海市200127

出　　处：《临床超声医学杂志》2017年第10期652-655,共4页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金(81571678);上海市科学技术委员会科研计划项目(14411968200);上海交通大学医学院附属仁济医院横向课题(RJKY14-07)

摘　　要：目的探讨超声造影评估乳腺癌新辅助化疗疗效的临床价值。方法选取行乳腺癌新辅助化疗及手术治疗的患者51例,分别于化疗前及手术前行超声造影检查,将最终的病理结果与化疗前穿刺标本进行比较,根据病理反应性分级标准(1~3级为无效,4~5级为有效),评估其化疗前后超声造影指标的变化。结果 51例患者中,化疗结束后治疗有效者25例,无效者26例。所有肿块化疗前均表现为高增强,化疗后有效者多表现为低增强(20例),无效者多表现为高增强或等增强(24例),两者比较差异有统计学意义(P<0.01)。化疗前无效者中出现灌注缺损区和放射状血管的概率明显高于有效者(P<0.05)。化疗后有效者峰值强度低,达峰时间长,区域血流量和血流速度均较无效者降低,差异均有统计学意义(均P<0.05)。结论超声造影对乳腺癌新辅助化疗疗效的预测及评估有一定临床价值。Objective To evaluate the clinical effect of neoadjuvant chemotherapy (NAC) for breast cancer by contrast-enhanced ultrasound (CEUS).Methods Fifty-one patients with breast cancer were enrolled in this study.CEUS was performed before and after NAC.According to the pathologic results of preoperation biopsy specimen and post-surgery samples,patients were divided into response group (including grade 4~5) and non-response group (including grade 1~3).Results In 51 patients,positive response was found in 25 patients,and negative response was found in another 26 patients.Hyper-enhancement was observed in all cases before chemotherapy by CEUS.Hypo-enhancement (20 cases)were observed in response group,while hyper/iso-enhancement (24 cases)were seen in non-response group.The enhancement were significantly different between the response group and the non-response group (P<0.01).The occurence of perfusion defect area and penetrating vessels were observed more frequently in the non-response group than those in the response group (P<0.05).Compared with the non-response group,lower peak intensity,lower regional blood volume and flow velocity,but higher peak time were observed in the response group (all P<0.05).Conclusion CEUS is potentially an effective method to assess and predicte the response of NAC in patients with breast cancer.

关 键 词：超声检查 造影剂 乳腺肿瘤 恶性 新辅助化疗 定量分析 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]