Dynamic Enhanced Magnetic Resonance And Diffusion-weighted Imaging Evaluation Of Breast Cancer To Neoadjuvant Chemotherapy Applied Research

Objective:Through measuring changes in the dynamic enhance magnetic resonance in maximum diameter line and diffusion tumor weighted imaging apparent diffusion coefficient (ADC) value during advanced breast cancer neo adjuvant chemotherapy (NAC), and forecasts the rate of change after the final chemotherapy tumor pathological reaction conditions.Materials and Methods:In 31 patients with breast cancer, dynamic contrast-enhanced MRI was performed before chemotherapy and after three chemotherapy cycles. MRI was performed on a 3.0-T Magnetom Trio scanner (Siemens Medical Solutions) with a dedicated bilateral phased-array breast coil. Images were acquired with the patient in the prone position and with both breasts imaged simultaneously. Dynamic enhance scanning contrast agents use gadolinium injection for acid Portuguese armour amine injection (GD-TDPA),0.2 mmol/kg, with 2ml/s velocity 20ml contrast agents, rapid regiment note contrast-enhanced sonogram obtained by former scanning piece 1 times, contrast-enhanced sonogram obtained after scanned continuously 6. In a dynamic increase scan, by scanning the before and after picture get silhouette images in the silhouette of the biggest image measurement tumor diameter line. The horizontal axis of bits, select b=1000s/mm2 measurement of tumor ADC values. Calculated respectively chemotherapy before and after the tumor maximum diameter line and ADC values the rate of change. Surgery after chemotherapy, all patients get final pathologic result, were divided into major histological response(MH R) group and non-major histological r esponse (NMHR) according to the pathologic response (Miller & Payne granding system). Receiver operating characteristic (ROC) analysis was used to develop a guideline that switches patients at high risk for incomplete remission.Results:Postoperative pathologic reactive MHR 10 cases, NMHR 21 cases. The comparison between the pathological group, in LD%, MHR group is higher than NMHR group; in ADC%, MHR group is higher than NMHR group. The area under the ROC curve of LD% is 0.986, and the area under the ROC curve of ADC% is 0.731. According to the statistical principle, the selection of truncated point LD%>62.50%, sensitivity of 75.00%, specificity of 83.30%; ADC%>15.53%, sensitivity for 81.00%, specificity of 71.90%Conclusion:MRI is advanced breast cancer NAC response evaluation of the main means. First, MRI imaging examinations are higher than other pathological coincidence rate; Second, MRI can from form and function aspects to evaluate, NAC function after changes earlier than morphological changes, and for vascular lesions area function of change and the forecast changes to reflect the chemotherapy can earlier the curative effect, MRI dynamic enhancement can assess NAC after changes in vessels DWI can pass the ADC values changes reflect organization constitute the molecular changes and cell structure change; Third, MRI zero radioactivity injury. Therefore, MRI can early in drug evaluation chemotherapy drug efficacy, earlier guide clinical treatment of adjustment, in clinical practical work with high application value.