摘要 目的探讨MRI多模态成像在炎性乳腺癌早期诊断和新辅助化疗后疗效评估中的价值。方法纳入36例临床确诊的炎性乳腺癌患者,分析乳腺MRI形态学、血流动力学及功能成像特征。其中11例患者同时进行了初诊时和新辅助化疗后MRI检查,分析新辅助化疗前后MRI影像征象的变化,并与术后病理结果对照,分析MRI评估新辅助化疗疗效的效能。结果36例患者,共38侧患乳,首诊MRI检查均可见患乳渗出广泛,皮肤异常增厚、强化;37侧患乳(97.4%)癌灶累及2个以上象限,25侧患乳(65.8%)乳内癌灶强化方式为非肿块样强化;33例(86.8%)患侧腋窝淋巴结肿大;MRI功能成像显示所有患者病变区域弥散受限,异常高灌注。与术后病理对照,MRI对术前乳内癌灶残留情况、脉管癌栓评估敏感度和特异度较高。结论MRI多模态成像可用于炎性乳腺癌的早期诊断以及预测、评估炎性乳腺癌新辅助化疗的疗效。 Objective To investigate the characteristics of magnetic resonance imaging and clinical application of multi-modality magnetic resonance imaging(MRI)for evaluating the response of neoadjuvant chemotherapy(NACT)in inflammatory breast cancer(IBC).Methods A total of 36 IBC patients were enrolled in the study.The morphological,hemodynamic and diffusion-weighted imaging features of MRI were analyzed.Eleven patients underwent MRI examination before and after NAT.The imaging changes were analyzed and the efficacy of NACT was evaluated.Results There were 38 identified breast carcinoma in these 36 cases,among which abnormal skin thickening and enhancement,extensive edema was found in 37 breast lesions.Enhancement of breast lesions in 25 cases was non-mass-like enhancement.Diffusion limitation was found in all lesions.The number of vessels in affected side was more than that in healthy side in MIP images.Thirty three cases had axillary lymph node enlargement.The sensitivity and specificity of MRI in evaluating residual breast tumors and vascular thrombus were high,but the evaluation of axillary lymph nodes was relatively low.Conclusions Multi-modal MRI can be used for early and accurate diagnosis of IBC.It can also be used to predict and evaluate the effect of neoadjuvant chemotherapy.
出处 《中华普通外科杂志》 CSCD 北大核心 2021年第4期295-300,共6页 Chinese Journal of General Surgery
关键词 炎性乳腺肿瘤 磁共振成像 弥散 肿瘤辅助化疗 动态增强 Inflammatory breast neoplasms Diffusion magnetic resonance imaging Neoadjuvant chemotherapy Dynamic enhancement
分类号 R73 [医药卫生—肿瘤]
