目的 探讨MRI增强扫描及表观扩 散系数(ADC)对乳腺癌化疗疗效的评估价 值。方法 以我院2013年1月-2015年1月接 受新辅助化疗治疗的50例乳腺癌患者为研 究对象，所有患者均于化疗前、化疗1周 期、化疗全程后行MRI检查，包括常规扫 描、增强扫描及扩散加权成像(DWI)，比 较化疗前后肿瘤轴位最大径、早期强化 率、ADC值变化，并根据病理疗效分为完 全缓解组与未完全缓解组，比较2组化疗 全程结束后肿瘤退缩率，对化疗全程后相 关参数之间行Spearman相关性分析。结果 化疗全程结束后轴位最大径、第1min、 2min、3min早期强化率较化疗前均明显下 降，ADCmean、ADCmin则显著上升，差异 有统计学意义(P＜0.05)。完全缓解组肿 瘤退缩率(0.690±0.193)，显著大于未完 全缓解组的(0.409±0.338)(P＜0.05)。 肿瘤退缩率与轴位最大径、早期强化率显 著相关(P＜0.05)，而与ADC值无相关性(P ＞0.05)。肿瘤退缩率54.45%以上时，诊 断完全缓解敏感度、特异度分别84.5%、 75.0%。结论 DWI的ADC值对乳腺癌新辅助 化疗早期反应有较大的价值，通过MRI增 强扫描及DWI序列观察肿瘤退缩率是预测 疗效的重要指标之一。

Objective To explore the value of MRI enhanced scan and apparent diffusion coefficient (ADC) in evaluating the curative effect of chemotherapy in breast cancer. Methods 50 cases of patients with breast cancer treated with neoadjuvant chemotherapy in our hospital from January 2013 to January 2015 were studied. All patients underwent MRI before chemotherapy, 1 cycle of chemotherapy later and after whole course of chemotherapy, including routine scan, enhanced scan and diffusion weighted imaging (DWI). The maximum axial diameter of tumor, early enhancement rate and changes of ADC values were compared before and after chemotherapy. According to the pathological curative effect, the patients were divided into complete remission group and incomplete remission group. The tumor regression rate at the end of the whole course of chemotherapy was compared between the 2 groups. For the related parameters after whole course of chemotherapy, Spearman correlation analysis was performed. Results After whole course of chemotherapy, the maximum axial diameters, early enhancement rates at the 1st min, 2nd min and 3rd min were significantly lower than those before chemotherapy while ADCmin and ADCmean increased significantly (P<0.05). The tumor regression rate in the complete remission group [(0.690±0.193)] was significantly greater than that in the incomplete remission group [(0.409±0.338)] (P<0.05). The tumor regression rate was significantly correlated with the maximum axial diameter and early enhancement rate (P<0.05) but was not correlated with ADC value (P>0.05). When the tumor regression rate was over 54.45%, the sensitivity and specificity in diagnosis of complete remission were 84.5% and 75% respectively. Conclusion ADC value of DWI has great value in early response to neoadjuvant chemotherapy for breast cancer. It is one of the important indicators to predict the curative effect by MRI enhanced scan and DWI sequence observing tumor regression rate