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1、DOI:10.13609/j.cnki.1000-0313.2007.12.020放射学实践2007年12月第22卷第12期RadiolPractice,Dec2007,Vol22,No.121249·乳腺影像学专题(二)·DWI对局部进展期乳腺癌新辅助化疗疗效评价的初步研究顾雅佳,冯晓源,邱龙华,彭卫军,杨文涛,费菲,陈灿敏,唐峰,毛健,邵志敏【摘要】目的:探讨磁共振扩散加权成像(DWI)对局部进展期乳腺癌新辅助化疗疗效评价以及作为预测因子的可行性。方法:根据10例乳腺癌化疗后退缩情况将肿瘤分成缓解和进展两组,比较两组化疗前后ADC值和DWI信号强度的变化,并评价治疗前ADC值与化疗结束
2、肿瘤退缩变化的相关性。结果:无论是治疗前还是治疗后,ADC值和DWI信号强度在缓解组和进展组间差异均无显著性意义(P>0.05),但缓解组治疗后ADC值升高,而进展组则降低,尤其在b=1000和2000s/mm2时明显。b=1000s/mm2时,肿瘤高活性区和低活性区对治疗反应比较显示,肿瘤高活性区ADC值较低,治疗后ADC值升高(1.195±0.230和1.371±0.295);而肿瘤低活性区ADC值较高,治疗后ADC值反而下降(1.632±0.241和1.312±0.297);与病理对照显示,治疗后肿瘤细胞蜕变,并伴有明显的胶元和纤维化形成。治疗前ADC值与治疗后肿瘤退缩呈负相关,当b
3、取1000和2000s/mm2时相关更明显,前者为r=-0.802,P=0.005,后者的r=-0.745,P=0.013。结论:DWI可以对局部进展期乳腺癌新辅助化疗疗效作评价,并能对治疗疗效作出预测。【关键词】乳腺肿瘤;磁共振成像;扩散加权成像;新辅助化疗【中图分类号】R445.2;R737.9【文献标识码】A【文章编号】1000-0313(2007)12-1249-07ResponseofLocallyAdvancedBreastCancertoNeoadjuvantChemotherapy:aPilotStudywithDiffusion-weightedMRIGUYa-jia,F
4、ENGXiao-yuan,QIULong-hua,etal.DepartmentofRadiology,theAffiliatedCancerHospitalofFudanUniversi-ty,Shanghai200032,P.R.China【Abstract】Objective:Toassessthefeasibilityofusingdiffusion-weightedMRIforpretreatmentpredictionandmoni-toringoftumorresponsetoneoadjuvantchemotherapyinpatientswithlocallyadvanc
5、edbreastcancer.Methods:Tenpatientsweredividedintoresponsegroupandprogressiongroupaccordingtothechangesoftumorsizeafterchemotherapy.ChangesinADCvalueandsignalintensity(SI)ofDWIwerecomparedbetweenthetwogroupsbeforeandafterthetreatment.Pre-treatmentADCswerecalculatedandcomparedwithposttreatmentchange
6、sintumorvolumesmeasuredonenhancedMRimagesbyusingtheSpearmancorrelationtest.Results:TheADCandSImeasuredbeforetherapyrevealednodifferencebe-tweentheresponsegroupandprogressiongroup(P>0.05),andnordidtheADCandSImeasuredaftertherapy.ButthemeanADCvalueoftheposttreatmentwasincreasedintheresponsegroup,whi
7、leitwasdecreasedintheprogressiongroup,whichwasespeciallyobviouswiththeuseofbvalue1000s/mm2or2000s/mm2diffusion-weightedMRimaging.Thepost-treatmentmeanADCvaluewasincreasedincomparisonwiththepretreatmentmeanADCvalu
