【摘要】 目的 比较乳腺DCE-MRI定量和半定量药代动力学参数在预测乳腺癌新辅助化疗疗效方面的价值。方法 入组患者为经穿刺病理确诊为乳腺癌并经新辅助化疗及手术治疗者，共61例病灶。根据术后病理Miller-Payne标准，将病灶分为显著反应组（21例）和非显著反应组（40例）。所有患者均在化疗前及化疗早期（第1疗程结束后）各进行1次结合高空间与时间分辨率的杂合DCE-MRI检查，测量DCE-MRI的定量与半定量药代动力学参数值。比较2组间各参数在化疗早期是否有统计学差异；ROC曲线分析诸参数对预测化疗疗效的价值。结果 第1疗程结束后，2组间前向容积转移常数(K^trans)、TIC、初始增强曲线下面积（IAUGC）、最大增强斜率（MaxSlope）有显著差异，对预测化疗疗效的AUC>0.7。定量参数联合后与半定量参数联合后的AUC无显著差异。结论 K^trans、TIC、IAUGC、MaxSlope对预测新辅助化疗疗效有价值；多指标联合后，定量与半定量参数有相近的预测效能。更多还原

【Abstract】 Objective To compare the predicting value of quantitative and semi-quantitative pharmacokinetic parameters of DCE-MRI in monitoring the response of breast cancers to neoadjuvant chemotherapy（NCT）.Methods The recruited patients with breast cancers were confirmed by biopsy before NCT and surgery, and 61 lesions were totally included.According to Miller-Payne criterion of the pathology from surgery, the lesions were divided into apparent（n=21） and non-apparent（n=40）histological response group.DCE-MRI,specially designed with high temporal and spatial resolution, was performed before and after the first cycle of the NCT,respectively.The values of quantitative and semi-quantitative pharmacokinetic parameters between groups were compared, and their predicting performance was analyzed with ROC curve.Results After the first cycle, forward volume transfer constant(K^trans),TIC,initial area under the gadolinium curve（IAUGC）,maximum slope of increase（MaxSlope） had significant difference between groups, with AUC>0.7.There was no significant difference between the AUC of quantitative parameters in combination and that of semi-quantitative ones in combination.Conclusion K^trans,TIC,IAUGC,MaxSlope have good predictive value for the effectiveness of NCT.Quantitative and semi-quantitative parameters have similar predicting performance.更多还原