目的分析磁共振成像动态增强 (DCE-MRI)定量参数联合磁共振扩散加权 成像(DWI)在评估乳腺癌新辅助化疗疗效 中的应用价值。方法 选取我院收治的90 例经穿刺病理活检确诊为乳腺癌患者，均 为浸润性导管癌，且行新辅助化疗(4-6 疗程)，在化疗前后接受DCE-MRI与DWI检 查，依据化疗后穿刺活检结果(是否再次 浸润)差异分为化疗缓解组(n=52)与无效 组(n=38)，比较2组化疗前后DCE-MRI定量 参数与DWI表观扩散系数(ADC)。结果 化 疗后，2组Kep、Ve、Ktrans均较化疗前产生 明显变化(P＜0.05），缓解组变化程度较 无效组更显著(P＜0.05)；2组ADCmin与 ADCmean均较化疗前明显增大(P＜0.05)， 缓解组增大程度较无效组更显著(P ＜0.05)；DCE-MRI联合DWI检查准确性 91.11%(82/90)、特异度94.74%(36/38)、 灵敏度88.46%(46/52)，Kappa值0.82。结 论 DCE-MRI定量参数联合DWI能评估乳腺 癌新辅助化疗后病灶浸润与转移情况，从 而准确判定乳腺癌新辅助化疗疗效，具有 较高应用价值。

Objective To analyze the application value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) quantitative parameters combined with diffusion weighted imaging (DWI) in evaluating the curative effect of neoadjuvant chemotherapy for breast cancer. Methods A total of 90 patients with breast cancer confirmed by puncture biopsy in the hospital were selected. All tumors were invasive ductal carcinomas, and they were treated by neoadjuvant chemotherapy (4-6 cycles). The patients were examined by DCE-MRI and DWI before and after chemotherapy, and according to the results of puncture biopsy (the presence of infiltrating again), the patients were divided into chemotherapy remission group (n=52) and ineffective group (n=38). The quantitative parameters of DCE-MRI and DWI apparent diffusion coefficient (ADC) were compared between the 2 groups before and after chemotherapy. Results There were obvious changes of Kep, Ve and Ktrans in the 2 groups before and after chemotherapy (P<0.05), and the change in the remission group was more significant than that in the ineffective group (P<0.05). The ADCmin and ADCmean in the 2 groups increased significantly after chemotherapy (P<0.05), and the increase in the remission group was more significant than that in the ineffective group (P<0.05). The accuracy, specificity, sensitivity and Kappa value of DCE-MRI combined with DWI were 91.11% (82/90), 94.74% (36/38), 88.46% (46/52) and 0.82, respectively. Conclusion DCE-MRI quantitative parameters combined with DWI can evaluate the invasion and metastasis of breast cancer after neoadjuvant chemotherapy, so as to accurately evaluate the curative effect of neoadjuvant chemotherapy for breast cancer.