CAJ | 학술논문

目的：探讨DCE‐MRI联合MSCT在晚期乳腺癌新辅助化疗疗效评估中的价值。方法回顾性分析2004年1月～2013年12月本院45例经穿刺活检确诊的进展期乳腺癌患者，分别行2～4周期新辅助化疗，化疗前后均进行DCE‐MRI及MSCT检查，对比化疗前后肿块最长直径、强化模式、腋窝淋巴结数目及大小等，并与术后病理学结果对照。结果 DCE‐MRI评估完全缓解（CR）者3例，部分缓解（PR）者30例，稳定（SD）者8例，进展（PD）者4例；MSCT评价CR者2例，PR者28例，SD者11例，PD者4例；DCE‐MRI、MSCT评价乳腺癌化疗后临床缓解率分别为73．3％、67．7％；化疗后病理缓解率为82．2％。结论 DCE‐MRI能够更好显示乳腺癌原发灶形态学、血流动力学变化，MSCT 更准确反应腋窝淋巴结的情况，还能发现肺内隐匿的转移灶。DCE‐MRI联合MSCT对预测乳腺癌新辅助化疗疗效具有重要价值。
목적：탐토DCE‐MRI연합MSCT재만기유선암신보조화료료효평고중적개치。방법회고성분석2004년1월～2013년12월본원45례경천자활검학진적진전기유선암환자，분별행2～4주기신보조화료，화료전후균진행DCE‐MRI급MSCT검사，대비화료전후종괴최장직경、강화모식、액와림파결수목급대소등，병여술후병이학결과대조。결과 DCE‐MRI평고완전완해（CR）자3례，부분완해（PR）자30례，은정（SD）자8례，진전（PD）자4례；MSCT평개CR자2례，PR자28례，SD자11례，PD자4례；DCE‐MRI、MSCT평개유선암화료후림상완해솔분별위73．3％、67．7％；화료후병리완해솔위82．2％。결론 DCE‐MRI능구경호현시유선암원발조형태학、혈류동역학변화，MSCT 경준학반응액와림파결적정황，환능발현폐내은닉적전이조。DCE‐MRI연합MSCT대예측유선암신보조화료료효구유중요개치。
Objective To investigate the value of DCE‐MRI and MSCT in assessment of therapeutic effect of neoadjuvant chemotherapy of advanced breast cancer .Methods 45 patients with advanced breast cancer confirmed by puncture biopsy between April 2004 and December 2013 were analyzed retrospectively .Treatment course was 2~4 periods .DCE‐MRI and MSCT were performed before and after neoadjuvant therapy .The tumor maximum diameter ,enhancement mode ,number and size of lymph nodes were measured before and after neoadjuvant therapy .Results DCE‐MRI assessed complete remis‐sion (CR) in 3 cases ,partial remission (PR) in 30 cases ,stable disease (SD) in 8 cases ,and progression of disease (PD) in 4 cases .2 CRs ,28 PRs ,11 SDs and 4 PDs were evaluated by MSCT .Clinical remission rates of advanced breast cancer after chemotherapy assessed by DCE‐MRI ,MSCT were 73 .3% ,67 .7% ,respectively .After chemotherapy ,pathological remission rate was 82 .2% .Conclusion DCE‐MRI can better display morphological and hemodynamic changes of primary breast cancer ;MSCT can show axillary lymph nodes more accurately and discover hidden metastasis in lung .DCE‐MRI combined with MSCT can accurately forecast the effect of neoadjuvant chemotherapy of breast cancer .