超声剪切波弹性成像联合二维超声对乳腺癌新辅助化疗疗效的评估

Neoadjuvant Chemotherapy of Ultrasonic Shear Wave Elastography Combined with Two-dimensional Ultrasound in Breast Cancer

目的:探讨超声剪切波弹性成像(SWE)联合二维超声对乳腺癌新辅助化疗(NAC)疗效评估。方法:应用SWE技术定量测定25例乳腺癌患者新辅助化疗(NAC)前后病灶的弹性模量值,比较病灶SWE模量最大值、最小值及Ratio比值,并观察SWE成像中乳腺癌"周氏环"征的变化;采用二维超声对NAC前后乳腺癌病灶左右、上下及前后直径进行测量并观察其变化,计算两种方法对NAC疗效的符合率。结果:与化疗前比较,化疗后SWE模量值的最大值、最小值及Ratio比值减小,NAC后乳腺癌病灶的"周氏环"消失;二维超声检测乳腺癌病灶左右、上下及前后直径减小,差异均有统计学意义(P<0.05);两种检查方法对治疗效果判断的符合率94%。结论:超声实时SWE成像结合二维超声能提高乳腺癌NAC疗效预测的准确性。

Objective： To discuss the therapeutic effect evaluation of neoadjuvant chemotherapy（ NAC） of ultrasonic shear wave elastography（ SWE） combined with two-dimensional ultrasound in breast cancer. Methods： Quantitative determination of elastic modulus in 25 breast cancer patients was conducted before and after neoadjuvant chemotherapy（ NAC） by SWE technique. The lesion SWE modulus maximum value,the minimum value and Ratio specific value were compared,and the changes of breast cancer ＂ Zhou ring＂ sign were observed in SWE imaging. Two-dimensional ultrasound was used to measure the left and right,upper and lower,front and back diameters of breast cancer before and after NAC,and observe the changes. The coincidence rate of 2 methods for NAC curative effect was calculated. Result： The maximum,minimum and Ratio specific value of SWE modulus decreased after chemotherapy,and breast cancer ＂ Zhou ring＂ disappeared after NAC. Two-dimensional ultrasound examined the breast cancer lesions on left and right,up and down as well as front and back,and diameter decreased. The differences were statistically significant（ P〈0. 05）. Conclusion： Real-time ultrasonic SWE imaging combined with two-dimensional ultrasound can improve the accuracy of breast cancer NAC prediction.