乳腺癌患者化疗后脑血流灌注异常的临床应用研究  

Clinical Application of Abnormal Cerebral Blood Perfusion in Breast Cancer Patients after Chemotherapy

作　　者：王宁[1] 夏建国[1] 田为中 胡剑峰 WANG Ning;XIA Jian-guo;TIAN Wei-zhong;HU Jian-feng(The Affiliated Taizhou People's Hospital of Nanjing Medical University,Taizhou Jiangsu 225300,China)

机构地区：[1]南京医科大学附属泰州人民医院影像科,江苏泰州225300

出　　处：《泰州职业技术学院学报》2024年第3期86-89,93,共5页Journal of Taizhou Polytechnic College

基　　金：江苏省卫健委科研课题(H2018093,课题负责人:田为中);江苏省第五期“333工程”科研项目(BRA2017175,项目主持人:夏建国).

摘　　要：目的应用磁共振成像中的动脉自旋标记(ASL)技术来探讨乳腺癌患者化疗后脑血流灌注变化及其与认知功能之间的相关性。方法前瞻性的收集43名自2020年1月至2022年12月经过手术病理证实的女性单侧乳腺癌患者(BC组),且所有患者在术后接受标准的化疗方案进行治疗。同时招募37名健康对照组(HC组),两组均采用西门子3.0T磁共振扫描仪进行常规头颅平扫及全脑ASL扫描,采用双样本t检验对各脑区脑血流量(CBF)值进行统计学分析。之后应用spearman相关性分析,探索存在血流灌注差异脑区的CBF值与神经量表之间的相关性。结果与HC组相比,BC组左侧小脑CrusII区、双侧颞中回CBF值降低,双侧豆状壳核CBF值增加(P<0.05,FWE校正)。相关性分析结果显示左侧小脑CrusII区、左侧颞中回、右侧颞中回CBF值与神经心理学量表MMSE呈正相关(r=0.429,P<0.01;r=0.413,P<0.01;r=0.405,P<0.01)。结论乳腺癌患者化疗后大脑存在多个脑区的脑血流灌注异常且存在与化疗相关的认知功能障碍。Objective To explore the correlation between the arterial spin labeling and cognitive function of pa⁃tients with breast cancer after chemotherapy based on arterial spin labeling(ASL)technology.Methods This study prospectively collected 43 female patients with unilateral breast cancer(BC group)confirmed by surgery and pa⁃thology at Taizhou People's Hospital from January 2020 to December 2022,and all patients received standard chemotherapy after surgery.At the same time,37 healthy control group(HC group)matched in age and educa⁃tion were recruited.Normal head scan and whole brain ASL scan were performed by Siemens 3.0T magnetic res⁃onance scanner in both groups,and the value of cerebral blood flow(CBF)in each brain area was statistically ana⁃lyzed by double-sample t test.Then spearman correlation analysis was used to explore the correlation between CBF value in brain area with blood perfusion difference and neural scale.Results Compared with the healthy control group,the CBF value of the left cerebellar CrusII and bilateral medial temporal gyrus decreased after che⁃motherapy,and the CBF value of bilateral liliform putamen increased(FWE correction).Correlation analysis showed that CBF values of left cerebellar CrusII area,left middle temporal gyrus and right middle temporal gyrus were positively correlated with neuropsychological scale MMSE(r=0.429,P<0.01;r=0.413,P<0.01;r=0.405,P<0.01).Conclusion There are abnormal cerebral blood perfusion in multiple brain regions and chemotherapy-re⁃lated cognitive dysfunction in breast cancer patients after chemotherapy.

关 键 词：脑血流灌注 动脉自旋标记技术 磁共振成像 认知功能障碍 

分 类 号：R445[医药卫生—影像医学与核医学]