【摘要】 目的 探讨MR T₂^*首过灌注成像（T₂^*-PWI）在乳腺癌中的应用及早期监测乳腺癌新辅助化疗疗效的价值。方法分析45例乳腺癌（均为浸润性导管癌）T₂^*-PWI,比较19例按疗程随访的PWI结果（化疗前,2个疗程后）,统计乳腺T₂^*-PWI成功率;并以负性增强积分、负性首过斜率及最大信号丢失率为分析数据源,观察分析新辅助化疗疗效。所有病例均经手术病理证实。结果 （1）乳腺癌的PWI成功率91.1%（41/45）,乳腺癌灶的负性灌注曲线表现为MR信号在短暂平台期后快速下降,较少或不出现信号强度恢复。（2）新辅助化疗中对治疗敏感的肿瘤负性灌注曲线渐趋平缓。比较化疗前,2疗程后肿瘤PWI负性灌注曲线测得的负性增强积分、负性首过斜率及最大信号丢失率（P<0.01）,2组差异有显著统计学意义。结论T₂^*-PWI可用于评价、预测乳腺癌新辅助化疗的疗效。更多还原

【Abstract】 Objective To evaluate the value of T₂^*-weighted first-pass perfusion imaging（T₂^*-PWI） in predicting early response to neoadjuvant chemotherapy（NAC）of locally advanced breast cancer（LABC）.Methods Forty-five patients with LABC（all vere invasive ductal carcinoma） proven by pathology underwent T₂^*-PWI.19 cases were followed-up by MR T₂^*-PWI before and after the second cycle of treatment.The successful rate of MR T₂^*-PWI was evaluated.The therapeutic effect was also evaluated based on the results of the score of negative enhancement,negative first-pass slope and the loss rate of maximum signal intensity.Results（1） Among 45 breast cancer,T₂^*-PWI was successfully performed in 41 cases（91.1 %）.Time-intensity curve showed sharp drop of MR signal intensity at the perfusion phase compared with pre-contrast baseline.（2） After 2 cycles of NAC,the negative enhanced integration negative first-pass slope and maximum signal-loss ratio of LABC decreased significantly（P<0.01）.The extent of signal intensity decreased and the slope of perfusion curve showed gradually even after therapy.Conclusion T₂^*-PWI can provide a sensitive assessment of treating efficacy in breast carcinoma.更多还原