磁共振动态增强扫描评价恩度在乳腺癌中的抗血管生成与抗肿瘤作用

目的：探讨M RI动态增强扫描评价恩度在乳腺癌中的抗血管生成与抗肿瘤作用的应用价值。方法选取2009年3月～2012年8月60例乳腺癌作为研究对象，随机分为实验组与对照组，分别接受恩度联合新辅助化疗、单独新辅助化疗治疗3个周期，在治疗前、后使用Siemens公司Magnetom Trio Tim 3．0T超导型磁共振进行扫描，在常规成像的基础上进行动态增强扫描。对动态增强的时间‐信号曲线进行定量分析，对比两组病例治疗前后瘤灶相应指标的变化，并将动态增强扫描结果与病理结果对照。结果治疗后实验组肿瘤的抑制率为（69．72±6．2）％，高于新辅助化疗对肿瘤的抑制率（48．71±5．8）％（ P ＜0．05）。实验组治疗后肿瘤的微血管成熟度较高，MVD分别为（3．7±1．7），低于对照组（5．1±2.8）（ P ＜0．05）。治疗后实验组反应肿瘤的血管通透性指标Ktrans在治疗后两组均较治疗前下降（ P ＜0．05），实验组下降了（0．32±0．11）ml／min ／100cm3，对照组下降了（0．14±0．08）ml／min ／100cm3，实验组高于对照组（ P ＜0.05）。两组肿瘤的血管外细胞外间隙Ve在治疗后均较治疗前缩小（ P ＜0．05），但实验组缩小了（0．40±0．14），而对照组仅缩小（0．19±0．12）（ P ＜0．05）。结论 DCE‐MRI可以作为抗血管生成治疗药物的疗效评价手段，Ktrans与Ve可以作为肿瘤M VD、血管通透性的代替生物标志。

Application of DCE-MRI in evaluating anti-angiogenesis and anti-tumor effect of Endostar in breast cancer

Objective To evaluate the application of dynamic contrast‐enhanced MRI in evaluating the anti‐angiogenesis and anti‐tumor effect of endostar in breast cancer .Methods From March 2008 to August 2012 ,60 cases of breast cancer were enrolled in as research subjects and randomly divided into experimental and control group .These two groups were treated with endostar combined with neoadjuvant chemotherapy and neoadjuvant chemotherapy for 3 cycles respectively . All patients underwent MRI examination before and after treatment using MAGNETOM Trio Tim 3 .0 T superconductive MRI scanning system from the SIEMENS company .Dynamic contrast enhanced magnetic resonance imaging was adminis‐tered with Gd‐DTPA on the basis of conventional imaging .The time signal enhancement curve of DCE‐MRI was quantita‐tively analyzed .We compared the changes of tumors in the two groups after treatment and compared dynamic enhanced MRI results with pathologic findings .Results After treatment ,the inhibition ratio of the tumour in the experimental group was （69 .7 ± 6 .2）% ,higher than that in the control group （48 .71 ± 5 .8）% （ P〈0 .05） .The MVD of tumor were （3 .7 ± 1 .7） in the experiment group ,and （5 .1 ± 2 .8） in the control group （ P 〈0 .05） .TIC curve in the experimental group was more smooth ,and lower than that in the control group .Ktrans which reflected vascular permeability of tumor after treatment was lower than that before in both groups （ P 〈 0 .05） .The experimental group decreased by （0 .32 ± 0.11） ml/min/100cm3 ,and the control group decreased by （0 .140 .08）ml/min/100 cm3 .The decrease in the experimental group significantly was higher （ P 〈0 .05） .Ve that reflected tumor extravascular extracellular space reduced after treat‐ment （ P 〈0 .05） ,but the experimental group reduced by （0 .40 ± 0 .14） ,while ,the control group reduced （0 .19 ±0.12） ,and the difference was statistically significant （ P 〈0 .05） .Conclusion So ,DCE‐MRI can