剪切波弹性成像联合声辐射力脉冲弹性成像对乳腺癌新辅助化疗效果的评价  

Evaluation of SWE combined with ARFI elastic imaging on the effect of neoadjuvant chemotherapy for breast cancer

作　　者：徐珍望 吴轶萍[1] 权露 周玲 XU Zhen-wang;WU Yi-ping;QUAN Lu(Department of Ultrasound Imaging,Huangshi Central Hospital Affiliated Hospital of Hubei Polytechnic University,Huangshi 435000,China)

机构地区：[1]黄石市中心医院(湖北理工学院附属医院)超声影像科,湖北黄石435000

出　　处：《中国医学装备》2023年第10期48-53,共6页China Medical Equipment

基　　金：湖北省卫生健康委第一批联合基金立项(WJ2019H179)“剪切波弹性成像与声辐射力脉冲弹性成像对乳腺癌新辅助化疗效果的评价”。

摘　　要：目的:探究剪切波弹性成像(SWE)联合声辐射力脉冲成像(ARFI)对乳腺癌新辅助化疗效果的评价。方法:选取医院收治的98例采用新辅助化疗的乳腺癌患者,根据乳腺癌Miller-Panye分级法评估术后患者残留肿瘤细胞百分比病理结果,将其分为病理显著反应组(70例)和非显著反应组(28例),分别对两组进行SWE与ARFI检测,比较两组化疗不同周期末病灶最大径(Dmax)、病灶最大弹性值(Emax)剪切波速度(SWV)值、Emax变化率(ΔEmax)、SWV缩小率(ΔSWV)值;采用受试者工作特征(ROC)曲线下面积(AUC)分析化疗后1周期末、2周期末和4周期末的ΔE_(max)、ΔSWV值与ΔE_(max)联合ΔSWV预测化疗疗效的效能。结果:在98例患者中,乳腺癌Miller-Panye分级法评估为G1级病灶6个、G2级病灶14个、G3级病灶41个、G4级病灶18个、G5级病灶11个。显著反应组70个(占71.43%),非显著反应组28个(占28.57%)。显著反应组化疗后1周期末、2周期末和4周期末ΔEmax值均高于非显著反应组(t=4.698,t=7.075,t=7.255;P<0.05)。显著反应组化疗后1周期末、2周期末、4周期末ΔSWV值均高于非显著反应组,其差异有统计学意义(t=4.852,t=7.204,t=5.967;P<0.05)。ROC曲线分析,化疗后1周期末、2周期末和4周期末的ΔE_(max)、ΔSWV预测乳腺癌新辅助化疗疗效的AUC分别为:ΔE_(max)为0.753、0.885和0.841;ΔSWV为0.754、0.870和0.762;将化疗后1周期末、2周期末和4周期末ΔE_(max)、ΔSWV纳入Logistic回归模型,1周期末、2周期末和4周期末两项联合预测乳腺癌新辅助化疗疗效的AUC分别为0.834、0.951和0.930。结论:SWE联合ARFI评估乳腺癌新辅助化疗疗效具有较好价值,且化疗后2周期末ΔEmax联合ΔSWV值预测价值最高,时机最优。Objective:To investigate the evaluation of shear wave elastography(SWE)combined with acoustic radiation force impulse(ARFI)elastic imaging on the effect of neoadjuvant chemotherapy for breast cancer.Methods:Ninety-eight patients with breast cancer admitted to hospital for neoadjuvant chemotherapy were selected.They were divided into pathologically significant response group(70 cases)and non-significant response group(28 cases)according to the pathological results of the percentage of residual tumor cells of postoperative patients who were assessed by Miller-Panye grading method of breast cancer.Both two groups underwent SWE and ARFI examinations,and the maximum diameter(Dmax)of lesion,the maximum elasticity value(Emax)of lesion,the value of shear wave velocity(SWV),the rate of Emax change(ΔEmax),the value of reduction rate of SWV(ΔSWV)at the end of different cycles of chemotherapies of two groups were compared.The area under curve(AUC)of receiver operating characteristics(ROC)was adopted to analyze the efficiencies ofΔEmax value,ΔSWV value and the combination ofΔEmax andΔSWV at the end of 1 cycle,the end of 2cycles and the end of 4 cycles in predicting the curative effect of chemotherapy.Results:In 98 patients,the assessment results of Miller-Panye grading method of breast cancer indicated that 6 cases were G1 grade lesion,and 14 cases were G2 grade lesion,and 41 cases were G3 grade lesion,and 18 cases were G4 grade lesion,and 11 cases were G5 grade lesion.There were 70 cases(71.43%)in the pathologically significant response group and 28 cases(28.57%)in the non-significant response group.The ΔE_(max) values at the end of 1 cycle,the end of 2 cycle and the end of 4 cycle in significant response group were significantly higher than those in the non-significant response group(t=4.698,t=7.075,t=7.255,P<0.05),respectively.The ΔSWV values at the end of 1 cycle,the end of 2 cycle and the end of 4 cycle in the significant response group were significantly higher than those in the non-significant response group,an

关 键 词：乳腺癌 新辅助化疗效果 剪切波弹性成像(SWE) 声辐射力脉冲成像(ARFI) 预测价值 

分 类 号：R445.1[医药卫生—影像医学与核医学]