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[磁共振扩散加权成像评估乳腺癌对新辅助化疗的病理反应]

[Evaluation of pathologic response of breast cancer to neoadjuvant chemotherapy with magnetic resonance diffusion weighted imaging].

作者信息

Luo Yi, Yu Jiangqun, Xu Zhongzi, Zeng Hanjiang, Chen Hui

出版信息

Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2014 Dec;31(6):1336-41.

Abstract

This paper aims to investigate the value of diffusiion weighted imaging (DWI) and different apparent diffusion coefficient (ADC) methods to predict the curative effects of neoadjuvant chempotherapy (NAC) for breast cancer. From March 2010 to December 2012, seventy-one patients were pathologically confirmed invasive breast cancer by needle puncture biopsy received before surgery, and underwent magnetic resonance before and after NAC, the ADC were measured by mean ADC method and lower ADC method. The pathologic response after NAC was divided to major histological response (MHR) group and non-major histological response (NMHR) group according to Miller & Payne system. Results displayed that ADC values obtained before NAC, at the end of the second cycle of NAC, and after whole course of treatment, had good correlations between mean and lower ADC methods (the Pearson's correlation=0.699, 0.749 and 0.895, respectively). Significant difference in ADC obtained both with mean and lower ADC methods could be found between MHR and NMHR groups after the second cycle of NAC (P< 0.05). After the second cycle of NAC, significant difference in the change rate of ADC could be found between MHR and NMHR groups by using lower ADC method (P<0.05), but not be found by using mean ADC method (P >0.05). In conclusion, DWI could monitor the pathologic changes of breast cancer after NAC, and the lower ADC method might be used to evaluate the curative effect of NAC with the change rate of ADC.

摘要

本文旨在探讨扩散加权成像(DWI)及不同表观扩散系数(ADC)方法预测乳腺癌新辅助化疗(NAC)疗效的价值。2010年3月至2012年12月,71例经手术前穿刺活检病理确诊为浸润性乳腺癌的患者在NAC前后接受磁共振检查,采用平均ADC法和较低ADC法测量ADC值。根据Miller & Payne系统将NAC后的病理反应分为主要组织学反应(MHR)组和非主要组织学反应(NMHR)组。结果显示,NAC前、NAC第二周期结束时及整个疗程后获得的ADC值,平均ADC法与较低ADC法之间具有良好的相关性(Pearson相关系数分别为0.699、0.749和0.895)。NAC第二周期后,MHR组和NMHR组在平均ADC法和较低ADC法测得的ADC值上均存在显著差异(P<0.05)。NAC第二周期后,采用较低ADC法时,MHR组和NMHR组在ADC变化率上存在显著差异(P<0.05),而采用平均ADC法时未发现显著差异(P>0.05)。综上所述,DWI可监测NAC后乳腺癌的病理变化,较低ADC法可通过ADC变化率评估NAC的疗效。

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