联合DWI和DCE-MRI评估乳腺癌新辅助化疗的应用价值  

Combining DWI and DCE-MRI in assessment of the clinical value of neoadjuvant chemotherapy in breast cancer

作　　者：张晓晶[1] 王习[2] 娄昕[1] 张爱莲[1] 吴南洲[1] 马林[1] ZHANG Xiaojing;FANG Xi;LOU Xin;ZHANG Ailian;WU Nanzhou;MA Lin(Department of Radiology,Chinese PLA General Hospital,Beijing 100853,P.R.China;Imaging Center,Affiliated Hospital of Weifang Medical University,Weifang 261031,P.R.China)

机构地区：[1]中国人民解放军总医院放射诊断科,北京100853 [2]潍坊医学院附属医院影像中心,山东潍坊261031

出　　处：《医学影像学杂志》2018年第5期758-761,共4页Journal of Medical Imaging

摘　　要：目的分析乳腺癌新辅助化疗前后DCE-MRI和DWI影像特征改变,评估二者联合磁共振成像技术在乳腺癌新辅助化疗评估中的应用价值。方法从经病理诊断的乳腺癌患者70例中筛选需要进行新辅助化疗的患者29例,在治疗前后行乳腺MRI检查,包括DCE-MRI和DWI检查,分析肿瘤ADC值、动态增强曲线和肿瘤径线治疗前后变化特点。新辅助化疗后对切除病理标本进行HE染色和免疫组化染色,分析肿瘤组织变化特征。结果化疗前ADC值平均值从(0.96±0.17)mm^2/s治疗后升高至(1.00±0.17)mm^2/s(P=0.408)。治疗前乳腺癌体积为(32.79±59.45)mm^3、治疗后体积(18.14±37.67)mm3(P=0.004)。治疗前动态增强曲线28例为3D型曲线,治疗后3D型曲线22例。术后病理显示新辅助化疗后肿瘤细胞残留降低至32.69%。结论新辅助化疗能够有效提高乳腺癌治疗效果,联合DWI和DCEMRI可精准评估治疗后肿瘤组织变化特点,具有较高的临床应用价值。Objective To analyze the changes of DCE-MRI and DWI imaging features before and after neoadjuvant chemotherapy in breast cancer,and to evaluate the value of the combined two magnetic resonance imaging（MRI） techniques in the evaluation of neoadjuvant chemotherapy for breast cancer. Methods 29 cases were selected pathologically from 70 patients with breast cancer screening,who needed neoadjuvant chemotherapy before and after treatment with breast MRI examination,including DCEMRI and DWI sequence. We analyzed the ADC values of tumor and tumor size before and after the curve line treatment characteristics of dynamic enhancement. After neoadjuvant chemotherapy,HE staining and immunohistochemical staining were performed to analyze the pathological changes of tumor tissues. Results The mean value of ADC before chemotherapy was reduced from 0. 96 ± 0. 17 to 1. 00 ± 0. 17（P = 0. 408） after treatment. Before treatment,the volume of breast cancer was 32. 79 ± 59. 45,After treatment,the volume was about 18. 14 ± 7. 39（P = 0. 004）. Before treatment,28 cases of dynamic enhancement curve were curve 3D. After treatment,22 cases of dynamic enhancement curve were curve 3D,and the pathological changes of tumor cells were reduced to 32. 69% after neoadjuvant chemotherapy after operation of the treatment. Conclusion Neoadjuvant chemotherapy can effectively improve the therapeutic effect of breast cancer,combined with DWI and DCE-MRI can accurately assess the characteristics of tumor tissue after treatment with a high clinical value.

关 键 词：乳腺癌 磁共振成像 新辅助化疗 

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