IntroductionAnthracycline chemotherapy drugs can produce cardiotoxicity in patients with breast cancer, leading to myocardial cell death and fibrosis, further developing into cardiac failure. However, the condition of myocardial microcirculation was unknown in breast cancer after anthracycline chemotherapy. As a result, intravoxel incoherent motion (IVIM) imaging was used to non-invasively observe the condition of myocardial microcirculation in a patient with breast cancer after anthracycline chemotherapy.Case reportA 43-year-old female patient with a right breast lump was reported. Preoperative ultrasound-guided needle biopsy showed invasive carcinoma of the right breast with fibroadenoma. Sentinel lymph node biopsy combined with simplified radical surgery for right breast cancer was performed. Postoperative pathological findings reported breast cancer (pT2N2M0 IIIA). The patient underwent eight sessions of the EC-TH chemotherapy scheme, and the EC and the TH schemes were adopted for the first four sessions and the last four sessions, respectively. During chemotherapy, during which there was the occurrence of Grade II myelosuppression, chest CT and abdomen CT showed no metastasis, and ECG and cardiac ultrasound reports returned to normal. Cardiac cine magnetic resonance and IVIM imaging were performed at the beginning of the first chemotherapy session (baseline) and after the third, fifth, and eighth chemotherapy sessions, respectively. We found that the fast apparent diffusion coefficient (ADCfast) and f parameters appeared to show a downward trend from the baseline to the fifth chemotherapy session, where the IVIMfast values declined from 163 × 10−3 mm2/s to 148 × 10−3 mm2/s and finally to 134 × 10−3 mm2/s and f values declined from 45% to 36% and then to 30%, respectively. ADCfast and f values showed an inclination from the fifth and eighth chemotherapy sessions.ConclusionOur case report showed that IVIM technology can likely detect non-invasive myocardial microcirculation early and quantitatively after anthracycline chemotherapy in patients with breast cancer. That is, IVIM technology seems to be helpful for cardiovascular risk monitoring and prognosis assessment of myocardial microcirculation in patients with breast cancer after anthracycline chemotherapy.
Background Intravoxel incoherent motion imaging (IVIM) can non-invasively evaluate diffusion and microvascular perfusion. Purpose To explore the myocardium microcirculation of a healthy Chinese population by using cardiac magnetic resonance (CMR) IVIM. Material and Methods A total of 80 healthy volunteers (44 men, 36 women) who underwent 3.0-T CMR examination were enrolled. All participants had cardiac cine imaging and short-axis CMR-IVIM of the left ventricle (LV) using multiple b-values. The consistency of the IVIM parameters was assessed by intraclass correlation coefficient (ICC) and the Bland–Altman test. Spearman correlation analysis was performed between IVIM parameters and age, and body mass index (BMI). The differences of IVIM parameters were analyzed between gender and different ages. Results LV end-diastolic volume (EDV), end-systolic volume (ESV), LVmass, cardiac output (CO), and BMI in the male group were higher than those in the female group ( P<0.05). IVIM parameters had good intra-observer and inter-observer consistency (≥0.75). Bland–Altman analysis also showed good intra-observer and inter-observer consistency. ADCfast decreased with increasing female age (rs = –0.37; P = 0.01), while IVIM parameters had no correlation with BMI regardless of sex. ADCfast in the female group had a statistical difference between different age groups. The ADCslow and f in the male group were lower than those in the female group ( P<0.05); however, there was no statistical difference in ADCfast between genders. Conclusion IVIM parameters in healthy Chinese volunteers provided good consistency. There was a negative correlation between ADCfast and age in the female group.
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