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目的探讨MRI在乳腺癌脑转移疗效评价中的价值,以合理选择检查方法。方法选择明确诊断的乳腺癌脑转移瘤患者65例,在放疗前和放疗后1月行头颅MRI常规平扫及增强(T1WI、FLAIR),采用实体瘤疗效评价标准(RE-CIST)1.1版作为评价脑转移肿瘤放疗疗效的标准。结果 65例患者放疗后,头颅MRI平扫及增强复查,以RECIST1.1评价结果显示,完全缓解8例(12.3%),部分缓解37例(56.9%),稳定16例(24.6%),进展4例(6.2%)。放疗前后平扫FLAIR序列中瘤周水肿显示较佳;DWI序列中瘤周水肿与脑室及脑沟脑积液无明显交通者,瘤周水肿显示较佳;增强T1WI、FLAIR序列中肿瘤大小和瘤周水肿显示较佳。结论 MRI可从多个体位评价病灶,同时可从平扫FLAIR、DWI和增强T1WI、FLAIR序列进行综合疗效评价。
Objective To investigate the value of MRI in the evaluation of curative effect of brain metastases of breast cancer, so as to choose reasonable examination methods. Methods Sixty-five patients with definite diagnosis of metastatic brain tumors of breast cancer were selected. Conventional cranial MRI scans and enhancements (T1WI, FLAIR) were performed before radiotherapy and one month after radiotherapy. The standard of evaluation of solid tumor efficacy (RE-CIST) version 1.1 was used as To evaluate the efficacy of radiotherapy for brain metastases. Results After radiotherapy in 65 patients, cranial MRI plain scan and enhanced review, RECIST1.1 evaluation results showed that complete remission in 8 cases (12.3%), partial remission in 37 cases (56.9%), stable in 16 cases (24.6%), progress 4 cases (6.2%). Plain edema in FLAIR sequence before and after radiotherapy showed better peritumoral edema; there was no obvious traffic in peritumoral edema and brain and sulcus effusion in DWI sequence, and peritumoral edema was better; enhanced tumor size and tumor in T1WI, FLAIR sequence. Peripheral edema shows better. Conclusions MRI can evaluate lesions from multiple positions, and comprehensive curative effects can be evaluated from plain scan FLAIR, DWI, and enhanced T1WI, FLAIR sequences.