摘要
目的利用磁共振伪连续动脉自旋标记(pCASL)技术探讨乳腺浸润性导管癌化疗后脑血流量(CBF)的变化与记忆、认知的关系。资料与方法前瞻性选择2019年7月-2020年在12月陕西省核工业二一五医院肿瘤中心经术后病理证实的乳腺浸润性导管癌27例,术后均接受表柔比星、环磷酰胺、紫杉醇序贯化疗方案;同期纳入年龄、受教育程度相匹配的健康志愿者29例作为对照组。所有受试者进行听觉词语记忆(AVLT-H)和蒙特利尔认知评估量表(MoCA)测试,随后进行全脑高分辨率T1WI及pCASL像扫描。分析两组受试者的CBF图,利用RESTplus软件提取差异脑区CBF值;比较两组AVLT-H、MoCA评分,并分析存在差异脑区的CBF值与化疗后时间的相关性。结果两组受试者AVLT-H及MoCA评分差异无统计学意义(P>0.05)。与对照组比较,乳腺癌组右侧脑岛(t=-3.28,P<0.05)、左侧脑岛(t=-3.27,P<0.05)、左侧海马旁回(t=-3.41,P<0.05)血流量减低,左侧楔前叶血流量增高(t=3.64,P<0.05);左侧海马旁回CBF值与化疗结束后时间呈正相关(r_(s)=0.388,P=0.046),双侧脑岛、左侧楔前叶CBF值与化疗结束后时间无相关性(P>0.05)。结论乳腺浸润性导管癌患者化疗结束1年后无明显认知损伤,但存在左侧海马旁回、双侧脑岛及左侧楔前叶CBF异常,且左侧海马旁回CBF异常随化疗结束后时间推移逐渐恢复。
Purpose To explore the relationship between the change of cerebral blood flow(CBF)and its correlation with memory as well as cognitive ability of breast invasive ductal carcinoma after chemotherapy by using magnetic resonance pseudo continuous arterial spin labeling(pCASL).Materials and Methods Twenty-seven patients with invasive ductal carcinoma of the breast confirmed by pathology in the Cancer Center of Nuclear 215 Hospital of Shaanxi Province from July 2019 to December 2020 were prospectively selected.All patients received Epirubicin,Cyclophosphamide,Taxol sequential chemotherapy after surgery,and 29 healthy volunteers were included as the control group within the same period.All subjects were tested with auditory verbal learning test of Huashan version(AVLT-H)and Montreal cognitive assessment(MoCA),followed by whole brain T1WI and pCASL scans.CBF maps of the two groups were analyzed,and RESTplus was used to extract CBF values of different brain regions.AVLT-H and MoCA scales scores between the two groups were compared,and the correlation between CBF value of different brain regions and duration after chemotherapy was further analyzed.Results There was no significant difference in the score of AVLT-H and MoCA between the two groups(P>0.05).Compared with the control group,CBF values of right insula(t=-3.28,P<0.05),left insula(t=-3.27,P<0.05)and the left parahippocampal gyrus(t=-3.41,P<0.05)in the breast cancer group were significantly decreased,while the CBF value of left precuneus lobe was significantly increased(t=3.64,P<0.05).CBF value of left parahippocampal gyrus was positively correlated with the duration after chemotherapy(r_(s)=0.388,P=0.046),while the CBF value of the bilateral insula and the left precuneus was not correlated with the duration after chemotherapy(P>0.05).Conclusion Although the survivors of breast invasive ductal carcinoma have no obvious cognitive loss one year after chemotherapy,there are still abnormal CBF in the left parahippocampal gyrus,bilateral insula and left precuneus,and the CBF in the left parahippocampal gyrus gradually recovers with the duration after chemotherapy.
作者
刘同辉
张华文
李朋
冯伟
张明
LIU Tonghui;ZHANG Huawen;LI Peng;FENG Wei;ZHANG Ming(不详;Department of Medical Imaging,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2023年第3期207-210,240,共5页
Chinese Journal of Medical Imaging
基金
陕西省重点研发计划(2019SF-209)
咸阳市重点研发计划(L2022ZDYFSF026)。
关键词
乳腺肿瘤
磁共振成像
动脉自旋标记
化学疗法
辅助
Breast neoplasms
Magnetic resonance imaging
Arterial spin labeling
Chemotherapy,adjuvant
