DCE-MRI定量参数联合DWI在评估乳腺癌新辅助化疗疗效的临床研究  

Evaluation of the Curative Effect of Neoadjuvant Chemotherapy for Breast Cancer by DCE-MRI Quantitative Parameters Combined with DWI

作　　者：翟战胜[1] 李正 任继鹏[1] 周凤梅[1] 杨庆辉[3] 李静[4] ZHAI Zhan-sheng;LI Zheng;REN Ji-peng(Department of MRI Room,TheFirst Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院核磁共振,河南新乡453100 [2]新乡医学院第一附属医院放射科,河南新乡453100 [3]新乡医学院第一附属医院肿瘤科,河南新乡453100 [4]郑州市妇幼保健院优生遗传科,河南新乡453100

出　　处：《中国CT和MRI杂志》2018年第10期68-71,共4页Chinese Journal of CT and MRI

基　　金：河南省医学科技攻关计划项目(编号:201602045)

摘　　要：目的分析磁共振成像动态增强(DCE-MRI)定量参数联合磁共振扩散加权成像(DWI)在评估乳腺癌新辅助化疗疗效中的应用价值。方法选取我院收治的90例经穿刺病理活检确诊为乳腺癌患者,均为浸润性导管癌,且行新辅助化疗(4-6疗程),在化疗前后接受DCE-MRI与DWI检查,依据化疗后穿刺活检结果(是否再次浸润)差异分为化疗缓解组(n=52)与无效组(n=38),比较2组化疗前后DCE-MRI定量参数与DWI表观扩散系数(ADC)。结果化疗后,2组Kep、Ve、Ktrans均较化疗前产生明显变化(P<0.05),缓解组变化程度较无效组更显著(P<0.05);2组ADCmin与ADCmean均较化疗前明显增大(P<0.05),缓解组增大程度较无效组更显著(P<0.05);DCE-MRI联合DWI检查准确性91.11%(82/90)、特异度94.74%(36/38)、灵敏度88.46%(46/52),Kappa值0.82。结论DCE-MRI定量参数联合DWI能评估乳腺癌新辅助化疗后病灶浸润与转移情况,从而准确判定乳腺癌新辅助化疗疗效,具有较高应用价值。Objective To analyze the application value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)quantitative parameters combined with diffusion weighted imaging(DWI)in evaluating the curative effect of neoadjuvant chemotherapy for breast cancer.Methods A total of 90 patients with breast cancer confirmed by puncture biopsy in the hospital were selected.All tumors were invasive ductal carcinomas,and they were treated by neoadjuvant chemotherapy(4-6 cycles).The patients were examined by DCE-MRI and DWI before and after chemotherapy,and according to the results of puncture biopsy(the presence of infiltrating again),the patients were divided into chemotherapy remission group(n=52)and ineffective group(n=38).The quantitative parameters of DCE-MRI and DWI apparent diffusion coefficient(ADC)were compared between the 2 groups before and after chemotherapy.Results There were obvious changes of Kep,Ve and Ktrans in the 2 groups before and after chemotherapy(P<0.05),and the change in the remission group was more significant than that in the ineffective group(P<0.05).The ADCmin and ADCmean in the 2 groups increased significantly after chemotherapy(P<0.05),and the increase in the remission group was more significant than that in the ineffective group(P<0.05).The accuracy,specificity,sensitivity and Kappa value of DCE-MRI combined with DWI were 91.11%(82/90),94.74%(36/38),88.46%(46/52)and 0.82,respectively.Conclusion DCE-MRI quantitative parameters combined with DWI can evaluate the invasion and metastasis of breast cancer after neoadjuvant chemotherapy,so as to accurately evaluate the curative effect of neoadjuvant chemotherapy for breast cancer.

关 键 词：磁共振成像动态增强 磁共振扩散加权成像 乳腺癌 新辅助化疗 疗效 

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