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目的 对乳腺癌术前新辅助化疗后超声各指标的变化进行观察分析 ,旨在探讨超声对其疗效评价的意义。方法 42例进行新辅助化疗的乳腺癌患者 ,于化疗前、化疗后、手术前分别对乳腺癌原发灶及腋窝淋巴结进行观察及分析。结果 42例患者新辅助化疗后超声检查显示 ,3 2例乳腺癌原发灶体积显著缩小 ;形态不规则者由化疗前 3例增至化疗后 3 1例 ;周边有强回声带者由化疗前 16例降至化疗后 4例 ;边界清晰者由 15例增至化疗后 3 7例 ;肿物内回声偏多者由化疗前 2例增至化疗后 2 7例 ;化疗前未见囊性变 ,化疗后 3例发生囊性变 ;后方回声有改变者由 3 4例降至化疗后 9例 ;有 2 9例原发灶内血流丰富程度降低或消失 ;Vmax、RI值降低 (P <0 .0 5 ,P <0 .0 2 5 )。共发现 2 9枚肿大淋巴结 ,化疗后 2 1枚缩小或消失 ;有 7例淋巴结内可检测出血流信号 ,化疗后 5例血流丰富程度降低。结论 乳腺癌新辅助化疗后 ,原发灶和腋窝淋巴结的二维图像及彩色多普勒的多项指标发生显著性变化 ,超声检查有助于对乳腺癌化疗疗效的评价。
Objective To observe and analyze the changes of ultrasound parameters after preoperative neoadjuvant chemotherapy for breast cancer, aiming to explore the significance of ultrasound in evaluating its curative effect. Methods Forty-two breast cancer patients undergoing neoadjuvant chemotherapy were observed and analyzed before chemotherapy, after chemotherapy, and before surgery for primary breast cancer and axillary lymph node. Results Ultrasound examination of neoadjuvant chemotherapy in 42 patients showed that the volume of primary lesions of 32 breast cancers was significantly reduced; the irregularity of the morphological changes was increased from 3 cases before chemotherapy to 31 cases after chemotherapy; there were strong echogenic bands before chemotherapy. 16 cases were reduced to 4 cases after chemotherapy; those with clear boundaries increased from 15 cases to 37 cases after chemotherapy; those with more intramural echoes increased from 2 cases before chemotherapy to 27 cases after chemotherapy; no cystic changes were observed before chemotherapy. 3 cases of cystic degeneration occurred after chemotherapy, and changes in posterior echo were reduced from 34 cases to 9 cases after chemotherapy. Twenty-nine cases of primary lesions had reduced or disappeared blood flow richness; Vmax and RI values decreased (P < 0 .0 5 ,P <0 .0 2 5 ). A total of 29 swollen lymph nodes were found. After chemotherapy, 21 cases were reduced or disappeared. Seven cases of lymph nodes could detect blood flow signals. After chemotherapy, the blood flow was reduced in 5 cases. Conclusion After neoadjuvant chemotherapy for breast cancer, two-dimensional images of primary tumors and axillary lymph nodes and multiple indicators of color Doppler changes significantly. Ultrasonography is helpful to evaluate the efficacy of chemotherapy for breast cancer.