磁共振多序列成像在三阴性乳腺癌新辅助化疗后保乳手术中的应用  

Application of multi-sequence magnetic resonance imaging in breast conserving surgery after neoadjuvant chemotherapy in triple negative breast cancer

作　　者：童富云[1] 徐美玲[1] 张超 孙荣华[1] 阚庆辉 黄波 石勇胜 TONG Fuyun;XU Meiling;ZHANG Chao;SUN Ronghua;KAN Qinghui;HUANG Bo;SHI Yongsheng(Department of Breast and Thyroid Surgery,Fuling Central Hospital,Chongqing 408000,China)

机构地区：[1]重庆市涪陵中心医院乳腺甲状腺外科,408000

出　　处：《重庆医学》2021年第21期3687-3690,共4页Chongqing medicine

基　　金：重庆市涪陵区科技计划项目(FLKJ,2018BBB030)。

摘　　要：目的比较磁共振多序列成像与超声体表定位在三阴性乳腺癌(TNBC)患者接受新辅助化疗后保乳手术中的应用效果。方法选取2018年10月至2020年10月该院确诊的TNBC患者124例,均接受新辅助化疗(多西他赛联合卡铂),采用随机数字法分为对照组和观察组,每组62例。对照组采用超声体表定位法,观察组采用磁共振多序列成像(T1WI、T2WI、DWI、T2WI/SPAIR、DCE等)确定保乳手术切除范围。比较两组患者术前评估肿瘤最大径、肿瘤/乳房体积比,以及与实际手术切除肿瘤体积吻合率、切缘阴性率、手术时间、并发症发生率等。结果与对照组比较,观察组患者术前评估肿瘤最大直径、肿瘤/乳房体积比均缩小,实际手术切除肿瘤体积吻合率、切缘阴性率均提高,差异均有统计学意义(P<0.05);两组患者手术时间、并发症发生率比较,差异均无统计学意义(P>0.05)。结论MRI多序列成像可为TNBC新辅助化疗后保乳手术提供更准确的切除范围。Objective To compare the application effects of multi-sequence magnetic resonance imaging and ultrasound body surface localization in breast conserving surgery after neoadjuvant chemotherapy for the patients with triple negative breast cancer(TNBC).Methods A total of 124 patients with TNBC definitely diagnosed in this hospital from October 2018 to October 2020 were selected,treated by the neoadjuvant chemotherapy(docetaxel+carboplatin),and divided into the control group and observation group by adopting the random number table method,62 cases in each group.The control group adopted the ultrasound body surface localization method,and the observation group adopted the magnetic resonance multi-sequence imaging(T1WI,T2WI,DWI,T2WI/SPAIR,DCE,etc.)to determine the resection range of breast conserving surgery.The maximum tumor diameter,tumor/breast volume ratio,its anastomosis rate with actual excision tumor volume,negative rate of incision margin,operation time,incidence rate of complications etc.were compared between the two groups.Results Compared with the control group,the maximum tumor diameter and the tumor/breast volume ratio evaluated before operation in the observation group were significantly reduced,the anastomosis rate with actual tumor resection volume and the negative rate of incision margin were significantly increased,and the differences were statistically significant(P<0.05).There were no statistical differences in the operation time and occurrence rate of complications between the two groups(P>0.05).Conclusion The multi-sequence MRI can provide more accurate resection range in TNBC patients with breast conserving surgery after neoadjuvant chemotherapy.

关 键 词：三阴性乳腺癌 新辅助化疗 保乳手术 磁共振多序列成像 超声体表定位 

分 类 号：R737.9[医药卫生—肿瘤]