Objective To investigate the value of DCE‐MRI and MSCT in assessment of therapeutic effect of neoadjuvant chemotherapy of advanced breast cancer .Methods 45 patients with advanced breast cancer confirmed by puncture biopsy between April 2004 and December 2013 were analyzed retrospectively .Treatment course was 2~4 periods .DCE‐MRI and MSCT were performed before and after neoadjuvant therapy .The tumor maximum diameter ,enhancement mode ,number and size of lymph nodes were measured before and after neoadjuvant therapy .Results DCE‐MRI assessed complete remis‐sion (CR) in 3 cases ,partial remission (PR) in 30 cases ,stable disease (SD) in 8 cases ,and progression of disease (PD) in 4 cases .2 CRs ,28 PRs ,11 SDs and 4 PDs were evaluated by MSCT .Clinical remission rates of advanced breast cancer after chemotherapy assessed by DCE‐MRI ,MSCT were 73 .3% ,67 .7% ,respectively .After chemotherapy ,pathological remission rate was 82 .2% .Conclusion DCE‐MRI can better display morphological and hemodynamic changes of primary breast cancer ;MSCT can show axillary lymph nodes more accurately and discover hidden metastasis in lung .DCE‐MRI combined with MSCT can accurately forecast the effect of neoadjuvant chemotherapy of breast cancer .%目的：探讨DCE‐MRI联合MSCT在晚期乳腺癌新辅助化疗疗效评估中的价值。方法回顾性分析2004年1月～2013年12月本院45例经穿刺活检确诊的进展期乳腺癌患者，分别行2～4周期新辅助化疗，化疗前后均进行DCE‐MRI及MSCT检查，对比化疗前后肿块最长直径、强化模式、腋窝淋巴结数目及大小等，并与术后病理学结果对照。结果 DCE‐MRI评估完全缓解（CR）者3例，部分缓解（PR）者30例，稳定（SD）者8例，进展（PD）者4例；MSCT评价CR者2例，PR者28例，SD者11例，PD者4例；DCE‐MRI、MSCT评价乳腺癌化疗后临床缓解率分别为73．3％、67．7％；化疗后病理缓解率为82．2％。结论 DCE‐MRI能够更好显示乳腺癌原发灶形态学、血流动力学变化，MSCT 更准确反应腋窝淋巴结的情况，还能发现肺内隐匿的转移灶。DCE‐MRI联合MSCT对预测乳腺癌新辅助化疗疗效具有重要价值。
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