MRI在乳腺癌新辅助化疗疗效评估中的价值  

Value of MRI in evaluating the efficacy of neoadjuvant chemotherapy for breast cancer

作　　者：王婷婷[1,2] 周娟 吴霞 张少华 李日飞 戴应俊 盛复庚 WANG Ting-ting;ZHOU Juan;WU Xia;ZHANG Shao-hua;LI Ri-fei;DAI Ying-jun;SHENG Fu-geng(PLA 307 Clinical College,Anhui Medical University,Beijing 100071,China;Southern Hospital of the Fifth Medical Center,General Hospital of PLA,Beijing 100071,China;College of Veterinary Medicine,China Agricultural University,Beijing 100193,China)

机构地区：[1]安徽医科大学解放军307临床学院,北京100071 [2]解放军总医院第五医学中心南院区,北京100071 [3]中国农业大学动物医学院,北京100193

出　　处：《军事医学》2019年第6期464-468,共5页Military Medical Sciences

基　　金：国家自然科学基金（21575161）

摘　　要：目的探讨1.5T MRI量化参数在乳腺癌新辅助化疗(NAC)疗效评估中的应用价值。方法回顾性收集72例接受NAC的乳腺癌患者化疗前、化疗4周期后乳腺磁共振扩散加权成像及动态增强图像资料,以Miller&Payne标准评估术后病理结果,并将其分为完全反应组和未完全反应组,比较组间病灶收缩率、表观扩散系数(ADC)及早期强化率的变化差异。结果NAC前组间病灶直径、ADC值及早期强化率均无差异(P>0.05),化疗后完全反应组的病灶收缩率、ADC值及早期强化率的变化较未完全反应组明显(P<0.01)。以术后病理为标准,获得的受试者工作特征曲线下面积(AUC)分别为0.788、0.832及0.905,多参数联合获得的AUC为0.938。结论MRI显示的病灶大小、ADC值及早期强化率的变化可一定程度上反映乳腺癌的最终化疗效果,MRI量化参数可为乳腺癌治疗方案的调整提供参考。Objective To assess the role of 1.5T MRI quantitative parameters in the evaluation of efficacy of neoadjuvant chemotherapy(NAC)for breast cancer.Methods Diffusion weighted imaging and dynamic enhancement images of 72 patients with breast cancer who had received NAC before and 4 cycles after chemotherapy were collected retrospectively.The postoperative pathological results were evaluated by Miller&Payne standard and divided into the complete response group and incomplete response group respectively.The changes of lesion contraction rate,apparent diffusion coefficient(ADC)and early enhancement rate between the two groups were compared.Results There was no difference in lesion diameter,ADC value or early enhancement rate between the two groups before NAC(P>0.05).The changes of lesion contraction rate,ADC value or early enhancement rate in the complete reaction group after chemotherapy were more obvious than those in the incomplete reaction group(P<0.01).According to postoperative pathology,the areas under the receiver operating characteristic curves(AUC)of the subjects were 0.788,0.832 and 0.905,respectively,and the AUC obtained by the combination of multiple parameters was 0.938.Conclusion The changes of lesion size,ADC value and early enhancement rate shown by MRI can reflect the final effect of chemotherapy for breast cancer,and the quantitative parameters of MRI can provide reference for the adjustment of breast cancer treatment.

关 键 词：乳腺肿瘤 磁共振成像 新辅助化疗 疗效评估 

分 类 号：R737.9[医药卫生—肿瘤]