Evaluation Forthe Efficacy Of Neoadjuvent Chemotherapy In The Treatment Of Breast Cancer With Conventional Ultrasound And Contrast-enhanced Ultrasound

Objective: To explore the application value of treatment for breast tumors with the neoadjuvant chemotherapy using conventional ultrasound and contrast- enhanced ultrasound technology.Method: Sixty patients diagnosed with breast cancer were examined using conventional ultrasound and contrast-enhanced ultrasound methods before and after neoadjuvant therapy respectively. Relevant data of tumor including position, size, form, number, characteristic of echo, microcalcification, features and distribution of external and internal blood flow of the tumor were all recorded. The contrast agent SonoVue (Bracco) was prepared to 5ml milky microbubble suspension. Each patient was injected with the SonoVue (2.4ml) through elbow vein. 5ml Saline was injected to wash the pipe. Infusing characteristics of the contrast agent in the tumor were observed to record the contrast-enhanced ultrasound imaging on the condition of low mechanical index. All patients were diagnosed by Philips iU 22 color ultrasonic apparatus, with L9-3 transducer of 3-9MHz. Examination time is 120 second per person. After just infusing the contrast agent, analyze the saved image and then observe the enhanced features in the tumor. The automatic tracing Time-Intencity Curve was used to observe peak intensity of the contrast agent. The results were compared with molybdenum target and pathological diagnosis respectively.All data were expressed with mean±standard deviation(data conformed to normal distribution), or median±quartile range(not conformed). T-test or Wilcoxon test was used to analyze size change of breast tumor before and after neoadjuvant chemotherapy, size change of breast tumor observed by Ultrasound and molybdenum methods respectively, different results between contrast-enhanced ultrasound diagnosis and pathology examination. All the statistical analyses were performed using the SPSS 13.0 software. A threshold level of p<0.05 was used to indicate statistical significance.Results: According to the results of ultrasound 2D, tumor size of 60 patients pathological diagnosis with breast cancer was significantly smaller than that of pre-chemotherapy. Results of contrast-enhanced ultrasound show that area infused with contrast agent in breast tumor was smaller that of pre-chemotherapy. After the time strength quantitative analysis Gamma-variate, 95 percent of the patients'intensification of contrast-enhanced ultrasound also weakened for post-therapy measurements compared with pre-therapy ones. The results of pathology check showed that the death of the cell and the tissue was obvious. Compared the area where intensification of contrast-enhanced ultrasound weakened and the area where cell and tissue were dead, there is no significant difference. Conclusions:Compared with molybdenum, ultrasound and contrast-enhanced ultrasound technology can not only clearly reflect the diminution level of breast tumor, but also evaluate the condition of new vessel net safely, noninvasively,and directly. These may reflect the treatment effect of neoadjuvant chemotherapy to some extent and provide the basis for the selection of clinical curing solution.