• 四川大學(xué)華西醫(yī)院放射科(四川成都 610041);

目的  探討MRI擴(kuò)散加權(quán)成像在乳腺浸潤性導(dǎo)管癌新輔助化療(NAC)療效評價(jià)中的作用。
方法  30例乳腺浸潤性導(dǎo)管癌患者,術(shù)前NAC治療前后均行MRI常規(guī)掃描及擴(kuò)散加權(quán)成像檢查。由兩位有經(jīng)驗(yàn)的影像醫(yī)師獨(dú)立分析對比NAC治療前后腫瘤最大徑及表觀擴(kuò)散系數(shù)(ADC)的變化。采用配對t檢驗(yàn)分析腫瘤最大徑及ADC值變化。
結(jié)果  乳腺浸潤性導(dǎo)管癌NAC治療前的腫瘤最大徑為(4.33±0.83) cm,治療后為(2.04±0.64) cm,其腫瘤最大徑明顯縮?。≒<0.001)。b=1 000時(shí),NAC治療前后腫瘤平均ADC 值分別為(1.89±0.15) ×10-3mm2/s和(1.14±0.31) ×10-3mm2/s,NAC治療后病灶A(yù)DC 值減?。≒<0.05)。
結(jié)論  MRI擴(kuò)散加權(quán)成像可無創(chuàng)并準(zhǔn)確地評價(jià)NAC的治療效果,有助于療效評價(jià)和手術(shù)決策。

引用本文: 張麗芝,曾涵江,黃子星,余建群. MRI擴(kuò)散加權(quán)成像對乳腺浸潤性導(dǎo)管癌新輔助化療效果的評價(jià). 中國普外基礎(chǔ)與臨床雜志, 2013, 20(1): 88-91. doi: 復(fù)制

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4. Rouzier R, Mathieu MC, Sideris L, et al. Breast-con serving surgery after neoadjuvant anthracycline-based chemotherapy for large breast tumors[J]. Cancer, 2004, 101(5):918-925.
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7. 趙斌, 蔡世峰, 高佩虹, 等. MR 擴(kuò)散加權(quán)成像鑒別乳腺良惡性病變的研究[J]. 中華放射學(xué)雜志, 2005, 39(5): 497-500.
8. 劉溢, 謝敬霞, 韓鴻賓, 等. 磁共振擴(kuò)散加權(quán)成像在乳腺腫瘤的初步應(yīng)用[J] . 中國醫(yī)學(xué)影像技術(shù), 2003, 19(5): 548-551.
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10. 楊麗, 時(shí)高峰, 劉輝, 等. 磁共振擴(kuò)散加權(quán)成像及表觀擴(kuò)散系數(shù)值測量在乳腺良惡性病變鑒別診斷中的價(jià)值[J]. 臨床薈萃, 2011, 26(12): 1082-1085.
11. Sinha S, Lucas-Quesada FA, Sinha U, et al. In vivo diffusion-weighted MRI of the breast:potential for lesion characterization[J] . J Magn Reson Imaging, 2002, 15(6):693-704.
12. 于韜, 羅婭紅, 邱巖, 等. DWI 結(jié)合時(shí)間-信號強(qiáng)度曲線評價(jià)乳腺病變性質(zhì)的研究[J]. 現(xiàn)代腫瘤醫(yī)學(xué), 2009, 17(8):1461-1464.
13. 白偉, 陳自謙, 葉友強(qiáng), 等. 磁共振擴(kuò)散加權(quán)成像在乳腺良惡性病變中的診斷價(jià)值[J] . 臨床軍醫(yī)雜志, 2011, 39(2):272-274.
14. 徐成. MRI 在乳腺癌新輔助化療療效評價(jià)中的應(yīng)用研究[J]. 實(shí)用醫(yī)學(xué)影像雜志, 2010, 11(3): 198-201.
15. 謝潔林, 汪登斌, 陳克敏, 等. 乳腺磁共振擴(kuò)散成像表觀彌散系數(shù)值差異的比較研究[J]. 外科理論與實(shí)踐, 2008, 13(11):126-129.
16. Rajan R, Poniecka A, Smith T L, et al. Change in tumor cellula-rity of breast carcinoma after neoadjuvant chemotherapy as a vari-able in the pathologic assessment of response[J]. Cancer, 2004,100(7):1365-1373.
17. Padhani AR. Functional MRI for anticancer therapy assessment[J]. Eur J Cancer, 2002, 38(16): 2116-2127.
18. 金光韋, 蔡幼銓, 安寧豫, 等. 表觀擴(kuò)散系數(shù)預(yù)測乳腺癌新輔助化療反應(yīng)初探[J]. 中華放射學(xué)雜志, 2008, 42(3):289-293.
19. Lee KC, Moffat BA, Schott AF, et al. Prospective early responseimaging biomarker for neoadjuvant breast cancer chemotherapy[J]. Clin Cancer Res, 2007, 13(2 Pt 1):443-450.
20. Guo Y, Cai YQ, Cai ZL, et al. Differentiation of clinically benignand malignant breast lesions using diffusion-weighted imaging[J]. J Magn Reson Imaging, 2002, 161(2):172-178.
21. Sharma U, Danishad KK, Seemu V, et al. Longitudinal study of the assessment by MRI an d diffusion-weighted imaging of tumorresponse in patients with locally advanced breast cancer undergoingneoadjuvant chemotherapy[J]. NMR Biomed, 2009, 22(1):104-113.
22. 劉春萍, 潘華雄, 楊帆, 等. MRI 在乳腺癌新輔助化療后行保乳手術(shù)中的應(yīng)用[J]. 華中科技大學(xué)學(xué)報(bào)(醫(yī)學(xué)版), 2009, 8(3):374-376.
23. 劉蔭華, 劉倩. 客觀解讀RECIST (修訂版) 的臨床評價(jià)意義[J]. 中國實(shí)用外科雜志, 2010, 30 (1):31-33.
24. 金光韋, 蔡幼銓, 安寧豫, 等. 磁共振成像在乳腺癌新輔助化療療效評估中的應(yīng)用[J]. 軍事醫(yī)學(xué), 2012, 36(1):289-293.
  1. 1. Roben SM, Leach MO. Imaging biochemistry:applications to breast cancer[J]. Breast Cancer Res, 2001, 3(1):36-40.
  2. 2. Hylton N. MR imaging for assessment of breast cancer response to neoadjuvant chemotherapy[J]. Magn Reson Imaging Clin N Am, 2006, 14(3):383-389.
  3. 3. Smith IC, Hey SD, Hutcheon AW, et al. Neoadjuvant chemotherapy in breast cancer:significantly enhanced response with docetaxel[J]. J Clin Oncol, 2002, 20(6):1456-1466.
  4. 4. Rouzier R, Mathieu MC, Sideris L, et al. Breast-con serving surgery after neoadjuvant anthracycline-based chemotherapy for large breast tumors[J]. Cancer, 2004, 101(5):918-925.
  5. 5. Junkermann H, von Fournier D. Imaging methods for evaluating the response of breast carcinoma to preoperative chemotherapy[J]. Radiology, 1997, 37(9):726-732.
  6. 6. Pickles MD, Gibbs P, Lowry M, et al. Diffusion changes precede size reduction in neoadjuvant treatment of breast cancer[J]. Magn Reson Imaging, 2006, 24(7):843-847.
  7. 7. 趙斌, 蔡世峰, 高佩虹, 等. MR 擴(kuò)散加權(quán)成像鑒別乳腺良惡性病變的研究[J]. 中華放射學(xué)雜志, 2005, 39(5): 497-500.
  8. 8. 劉溢, 謝敬霞, 韓鴻賓, 等. 磁共振擴(kuò)散加權(quán)成像在乳腺腫瘤的初步應(yīng)用[J] . 中國醫(yī)學(xué)影像技術(shù), 2003, 19(5): 548-551.
  9. 9. 郭勇, 蔡祖龍, 蔡幼銓, 等. 彌散加權(quán)成像鑒別乳腺良惡性病變的價(jià)值初探[J] . 中華放射學(xué)雜志, 2001, 35(2): 132-135.
  10. 10. 楊麗, 時(shí)高峰, 劉輝, 等. 磁共振擴(kuò)散加權(quán)成像及表觀擴(kuò)散系數(shù)值測量在乳腺良惡性病變鑒別診斷中的價(jià)值[J]. 臨床薈萃, 2011, 26(12): 1082-1085.
  11. 11. Sinha S, Lucas-Quesada FA, Sinha U, et al. In vivo diffusion-weighted MRI of the breast:potential for lesion characterization[J] . J Magn Reson Imaging, 2002, 15(6):693-704.
  12. 12. 于韜, 羅婭紅, 邱巖, 等. DWI 結(jié)合時(shí)間-信號強(qiáng)度曲線評價(jià)乳腺病變性質(zhì)的研究[J]. 現(xiàn)代腫瘤醫(yī)學(xué), 2009, 17(8):1461-1464.
  13. 13. 白偉, 陳自謙, 葉友強(qiáng), 等. 磁共振擴(kuò)散加權(quán)成像在乳腺良惡性病變中的診斷價(jià)值[J] . 臨床軍醫(yī)雜志, 2011, 39(2):272-274.
  14. 14. 徐成. MRI 在乳腺癌新輔助化療療效評價(jià)中的應(yīng)用研究[J]. 實(shí)用醫(yī)學(xué)影像雜志, 2010, 11(3): 198-201.
  15. 15. 謝潔林, 汪登斌, 陳克敏, 等. 乳腺磁共振擴(kuò)散成像表觀彌散系數(shù)值差異的比較研究[J]. 外科理論與實(shí)踐, 2008, 13(11):126-129.
  16. 16. Rajan R, Poniecka A, Smith T L, et al. Change in tumor cellula-rity of breast carcinoma after neoadjuvant chemotherapy as a vari-able in the pathologic assessment of response[J]. Cancer, 2004,100(7):1365-1373.
  17. 17. Padhani AR. Functional MRI for anticancer therapy assessment[J]. Eur J Cancer, 2002, 38(16): 2116-2127.
  18. 18. 金光韋, 蔡幼銓, 安寧豫, 等. 表觀擴(kuò)散系數(shù)預(yù)測乳腺癌新輔助化療反應(yīng)初探[J]. 中華放射學(xué)雜志, 2008, 42(3):289-293.
  19. 19. Lee KC, Moffat BA, Schott AF, et al. Prospective early responseimaging biomarker for neoadjuvant breast cancer chemotherapy[J]. Clin Cancer Res, 2007, 13(2 Pt 1):443-450.
  20. 20. Guo Y, Cai YQ, Cai ZL, et al. Differentiation of clinically benignand malignant breast lesions using diffusion-weighted imaging[J]. J Magn Reson Imaging, 2002, 161(2):172-178.
  21. 21. Sharma U, Danishad KK, Seemu V, et al. Longitudinal study of the assessment by MRI an d diffusion-weighted imaging of tumorresponse in patients with locally advanced breast cancer undergoingneoadjuvant chemotherapy[J]. NMR Biomed, 2009, 22(1):104-113.
  22. 22. 劉春萍, 潘華雄, 楊帆, 等. MRI 在乳腺癌新輔助化療后行保乳手術(shù)中的應(yīng)用[J]. 華中科技大學(xué)學(xué)報(bào)(醫(yī)學(xué)版), 2009, 8(3):374-376.
  23. 23. 劉蔭華, 劉倩. 客觀解讀RECIST (修訂版) 的臨床評價(jià)意義[J]. 中國實(shí)用外科雜志, 2010, 30 (1):31-33.
  24. 24. 金光韋, 蔡幼銓, 安寧豫, 等. 磁共振成像在乳腺癌新輔助化療療效評估中的應(yīng)用[J]. 軍事醫(yī)學(xué), 2012, 36(1):289-293.