磁共振成像在乳腺癌新辅助化疗疗效评价中的应用

The application of MRI imaging in assessing the curative effect of neoadjuvant chemotherapy in breast cancer

目的：观察乳腺癌磁共振成像（MRI）与病理检查结果的符合情况，探讨 MRI 在乳腺癌新辅助化疗疗效评价中的价值。方法以98例乳腺癌患者为研究对象，所有患者行6个周期乳腺癌新辅助化疗，化疗后行手术切除，并在化疗前和化疗6个周期后接受乳腺 MRI 检查，分析 MRI 对乳腺癌新辅助化疗疗效评价与术后病理结果的一致性。结果98例乳腺癌患者经6个周期的新辅助化疗后，病理检查的总有效率为71.4％，MRI 检查的总有效率为74．5％，两种检查评价结果基本一致；MRI 对术后完全缓解患者评价的灵敏性、特异性、准确性分别为87．3％、67．1％、78．2％，对部分反应患者评价的灵敏性、特异性、准确性分别为92.5％、59.7％、85.9％。MRI 图像显示22例患者的肿瘤缩小方式为向心型缩小，23例为树枝型缩小，MRI 检查测得肿瘤最大直径与病理检查结果相差（0．42±0．27）cm。结论MRI 对乳腺癌新辅助化疗疗效评价与术后病理结果一致，有助于指导临床治疗和手术方案的选择，值得临床推广应用。

Objective To observe the consistency of MRI imaging and pathological examination.To discuss the value of MRI imaging in assessing the curative effect of neoadjuvant chemotherapy in breast cancer.Methods 98 patients with breast cancer were selected as research subjects.All patients received six cycles of neoadjuvant chemotherapy,and underwent surgical treatment after the end of chemotherapy.All of them were performed with MRI examination before and after 6 cycles of chemotherapy.The evaluation of MRI in assessing the neoadjuvant chemotherapy and postoperative efficacy of breast cancer were compared for the consistency.Results The total effective rate by pathological examination of 98 cases of breast cancer after 6 cycles of neoadjuvant chemotherapy was 71 .4%,and the effective rate by MRI examination was 74.5%,and two evaluation results were basically consistent.The sensitivity, specificity and accuracy of MRI to assess the complete response （CR）patients after chemotherapy were 87.3%, 67.1 % and 78.2%,respectively,which of the partial response（PR）patients were 92.5%,59.7% and 85.9%, respectively.The tumor shrinkage of 22 patients was reduced towards the heart,with 23 branches reduced according to the MRI image.The average gap between MRI measured maximum tumor diameter and pathological examination results was （0.42 ±0.27）cm.Conclusion The evaluation of MRI in assessing the neoadjuvant chemotherapy was consistent with the pathology results,which could be used for clinical treatment and surgery program,worthy of clinical application.