乳腺癌新辅助化疗前后动态增强MRI半定量

Breast Cancer with Neoadjuvant Chemotherapy:Alteration of Dynamic Enhancement-MRI Semi-quantitative Parameters

目的:用动态增强MRI半定量法研究乳腺癌新辅助化疗前后血流动力学的变化特点。方法:新辅助化疗的26例乳腺癌患者(女性,平均55.2岁)纳入研究,化疗前后采用同一方案进行乳腺动态MRI增强扫描,使用1.5T超导MRI成像仪、3D FSE序列(TR/TE:5.4ms/2.8ms;FOV:34cm;层厚:3mm;间隔:0mm),速度3ml/s团注钆喷葡胺0.2mmol/kg;在工作站上完成血流半定量测定,并对化疗前后结果进行比较。结果:化疗前早期强化参数Efirst、Vfirst、Ee和Ve的均值大于化疗后的残留病灶(P<0.05),化疗前Emax、Vmax和Slopemax的均值大于化疗后残留病灶的均值,化疗前Tmax均值小于化疗后均值(P<0.05),化疗前Ewash和Vwash值高于化疗后的残留病灶(P<0.05)。结论:乳腺癌新辅助化疗前后动态增强MRI半定量研究显示残留病变血流动力学明显下降,血流速率显著减小。

Purpose： To explore alteration of characteristics in dynamic enhancement - MRI（ DCE - MRI） semi - quantitative parameters. Methods： Twenty - six patients with surgically and pathologically proven breast carcinoma who had undergone breast DCE - MRI examation before and after neoadjuvant chemotherapy（NAC） were enrolled in our study. Three - dimensional fast spin echo images （3D - FSE） （TR/TE 5.4/2.8ms; FOV 34cm; Slice thickness 3.0ram; Gap 0ram） were acquired on a 1.5T MR system after administration of a bolus injection of 0.2mmol/kg gadopentetate dimeglumine . The semi - quantitative parameters of DCE - MRI were calculated on workstation and compared before and after NAC. Results： The semi - quantitative parameters had significant alteration before and after NAC, that were as followed： The mean value of Efirst, Vfirst, Ee, Ve, Emax, Vmax, Slopemax, Ewash, Vwash after chemotherapy were lower than those values before chemotherapy（P 〈 0.05）, Tmax was significant higher than that before chemotherapy（P 〈 0.05） . Conclusion： The mean value of semi - quantitative parameters had significant alteration in a reduced speed and decreased blood flow before and after NAC.