乳腺癌新辅助化疗前后采用DCE-MRI进行疗效评估的临床价值

目的 探讨乳腺癌患者实施新辅助化疗(NAC)治疗前后采用动态增强磁共振(DCE-MRI)检查进行疗效评估的临床价值.方法 选取82例实施NAC的乳腺癌患者的临床资料,所有患者均接受环磷酰胺+表柔比星+紫杉醇NAC方案,分别于化疗前、患者完成4～6个疗程后采用DCE-MRI进行检测,根据化疗效果将患者分为有效组、无效组,并对比DCE-MRI检测参数.结果 有效患者共54例,无效患者28例.化疗结束后,有效组患者的首过强化率、首过强化速率、早期强化率、早期强化速率、最大强化率、最大强化速率、最大强化斜率、达峰时间、ADC值、Ktrans、Ve、肿瘤直径变化值均明显高于无效组,差异均有统计学意义(P﹤0.01).结论 NAC治疗前后采用DCE-MRI检查可以对乳腺癌患者疗效进行有效评估.

Clinical value of DCE-MRI in the evaluation of breast cancer before and after NAC

Objective To investigate the clinical value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) before and after neoadjuvant chemotherapy (NAC) in patients with breast cancer. Method 82 patients with breast cancer who underwent NAC were enrolled in this study. All patients were treated with CET regimen (cyclophos-phamide+epirubicin+paclitaxel), and were examined with DCE-MRI before chemotherapy and 4 to 6 cycles after chemo-therapy, according to the results of treatment, patients were stratified as responsive or non-responsive to compared the pa-rameters of DCE-MRI detection. Result 54 patients were responsive, and 28 were not. After chemotherapy, the first-pass enhancement ratio, first-pass enhancement rate, early enhancement ratio, early enhancement rate, maximum enhance-ment ratio, maximum enhancement rate, time to peak, ADC value, Ktrans, Ve, change of tumor diameter in responsive pa-tients were significantly higher than in those who were non-responsive (P<0.01). Conclusion DCE-MRI examination be-fore and after NCE treatment is effective in evaluating the efficacy in breast cancer patients.