动态增强磁共振与扩散加权成像对乳腺癌新辅助化疗疗效评价的应用分析

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1、AbstractObjectire：Throughmeasuringchangesinthedynamicenhancemagneticresonanceinmaximumdiameterlineanddiffusiontumorweightedimagingapparentdiffusioncoefficient(ADC)valueduringadvancedbreastcancerneoadjuvantchemotherapy(NAC)，andforecaststherateofchangeafterthefinalchemotherapy

2、tumorpathologicalreactionconditions．MaterialsandMethods：In31patientswithbreastcancer，dynamiccontrast—enhancedMRlwasperformedbeforechemotherapyandafterthreechemotherapycycles．MRlwasperformedona3．0-TMagnetomTrioscanner(SiemensMedicalSolutions)withadedicatedbilateralphased—arra

3、ybreastcoil．Imageswereacquiredwiththepatientinthepronepositionandwithbothbreastsimagedsimultaneously．DynamicenhancescanningcontrastagentsusegadoliniuminjectionforacidPortuguesearmouramineinjection(GD—TDPA)，0．2mmol／kg，with2ml／svelocity20mlcontrastagents，rapidregimentnotecontr

4、ast—enhancedsonogramobtainedbyformerscanningpieceltimes，contrast——enhancedsonogramobtainedafterscannedcontinuously6．Inadynamicincreasescan，byscanningthebeforeandafterpicturegetsilhouetteimagesinthesilhouetteofthebiggestimagemeasurementtumordiameterline．Thehorizontalaxisofbit

5、s，selectb=1000s／mm2measurementoftumorADCvalues．CalculatedrespectivelychemotherapybeforeandafterthetumormaximumdiameterlineandADCvaluestherateofchange．Surgeryafterchemotherapy，allpatientsgetfinalpathologicresult，weredividedintomajorhistologicalresponse(姗R)groupandnon—majorhis

6、tologicalresponse(NMHR)accordingtothepathologicresponse(Miller＆Paynegrandingsystem)．Receiveroperatingcharacteristic(ROC)analysiswasusedtodevelopaguidelinethatswitchespatientsathighriskforincompleteremission．Results：PostoperativepathologicreactiveElR10cases，NEtR21cases．Thecom

7、parisonbetweenthepathologicalgroup，inLD96，ElRgroupishigherthanNElRgroup；inADc96，ElRgroupishigherthanNE4Rgroup．TheareaundertheROCcurveofLD96is0．986．andtheareaundertheROCcurveofADC％is0．731．Accordingtothestatisticalprinciple。theselectionoftruncatedpointLD％>62．50％，sensitivityof7

8、5．00％，specificityof83．30％：ADC％>15．53％，sensitivityfor81．00％，specificityof71．