IVIM在乳腺癌新辅助化疗后早期反应评估的应用价值

doi:10.12117/jccmi.2019.02.007

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摘要目的：本研究拟探讨基于体素内不相干扩散运动（IVIM）成像对乳腺癌新辅助化疗后早期反应的监测能力。方法：回顾性分析经过乳腺癌新辅助化疗女性患者30例，患者行多b值双指数信号衰减模型的IVIM检查，采用15个b值，分别为0、25、50、75、100、150、200、500、700、800、900、950、1 000、1 200、1 400 s/mm2。首先将病例分为化疗前组和化疗后组，又以病理诊断为金标准，将化疗后组分为有效组和无效组。结果：新辅助化疗前组与化疗后组比较，化疗后组ADCslow值明显增高，f值减小，两组具有统计学差异（P＝0.001；P=0.021），经2周期化疗后有效组与无效组相比，有效组ADCslow高于无效组，f值低于无效组，具有统计学差异（P＝0.000；P=0.000），ADCfast不具有统计学意义（P=0.408），ADCslow预测性能高于f值，曲线下面积AUC 88.9%，f的AUC为74.3%，ADCfast的AUC为64.9%。通过比较化疗前后两组差值，ΔADCslow与Δf有统计学意义（P＜0.05），曲线下面积分别为92.4%、88.9%，ΔADCfast无统计学意义（P=0.211），AUC为70.8%。结论：IVIM在乳腺癌化疗疗效的评估中有价值，其中ADCslow和f值具有潜在对化疗早期反应的评估价值，而ΔADCslow对化疗反应的评估价值最大。

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	熊发奎1
	崔凤1
	龚良庚2

关键词 ：乳腺肿瘤, 抗肿瘤联合化疗方案, 磁共振成像

Abstract：Objective: To investigate the monitoring ability of early response to neoadjuvant chemotherapy in breast cancer based on intravoxel incoherent motion(IVIM). Methods: A retrospective analysis was performed on 30 cases of female patients with breast cancer neoadjuvant chemotherapy, who underwent IVIM examination of multiple b-value dual exponential signal attenuation model. Fifteen b-values were used, including 0, 25, 50, 75, 100, 150, 200, 500, 700, 800, 900, 950, 1 000, 1 200, 1 400 s/mm2 respectively. We divided all cases into pre-chemotherapy group and post-chemotherapy group. And pathologic diagnosis as golden standard, divided post-chemotherapy group into valid group and invalid group. Results: Compared with pre-chemotherapy, ADCslow value increased and f value decreased significantly in post-chemotherapy group(P=0.001; P=0.021). After two cycles of chemotherapy ADCslow was higher in the valid group and f value was lower in the invalid group(P=0.000; P=0.000). ADCfast showed no statistical significance(P=0.408). The prediction performance of ADCslow was higher than f value with AUC of 88.9%. The AUC of f value and ADCfast were 74.3% and 64.9% respectively. After comparing the difference before and after chemotherapy, ΔADCslow and Δf value were statistically significant(P<0.05) with AUC of 92.4% and 88.9% respectively. ΔADCfast showed no statistical significance(P=0.211) and the AUC is 70.8%. Conclusion: IVIM has value in evaluating the efficacy of breast cancer chemotherapy. ADCslow and f value have such potential ability while ΔADCslow value most.

Key words： Breast neoplasms Antineoplastic combined chemotherapy protocols Magnetic resonance imaging

收稿日期: 2018-03-05

PACS:	Ｒ737.9
	Ｒ445.2

通讯作者: 崔凤，浙江省杭州市中医院放射科，310000。E-mail：feng6812@163.com

作者简介: 熊发奎（1989-），男，江西人，硕士研究生。E-mail：798910175@qq.com

引用本文:

熊发奎1，崔凤1，龚良庚2. IVIM在乳腺癌新辅助化疗后早期反应评估的应用价值[J]. 中国临床医学影像杂志, 2019, 30(2): 102-105.
XIONG Fa-kui1, CUI Feng1, GONG Liang-geng2. The application value of IVIM in the assessment of early reaction after neoadjuvant chemotherapy for breast cancer. JOURNAL OF CHINA MEDICAL IMAGING, 2019, 30(2): 102-105.

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http://www.jccmi.com.cn/CN/10.12117/jccmi.2019.02.007 或 http://www.jccmi.com.cn/CN/Y2019/V30/I2/102

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