Tozaki Mitsuhiro
Breast Center, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan.
Breast Cancer. 2008;15(3):218-23. doi: 10.1007/s12282-008-0048-x.
Magnetic resonance imaging (MRI) of the breast has emerged as a highly sensitive modality. In addition to morphologic and kinetic analysis obtained from contrast-enhanced breast MRI, functional information has been needed for diagnosis of breast disease. In vivo proton (hydrogen 1 [(1)H]) MR spectroscopy of the breast has demonstrated that choline (Cho) can be detected in breast cancers, whereas Cho is generally undetectable in normal breast tissue. Thus, breast MR spectroscopy has shown great promise as a way to differentiate between benign and malignant lesions and to gauge the effect of chemotherapeutic agents in patients with locally advanced breast cancer. Prior studies performed on 1.5-T MR imagers have reported sensitivities of 70-100% (average 89%; 149/168) and specificity of 67-100% (average 87%; 97/112) for breast MR spectroscopy. Moreover, the presence of a Cho peak in breast cancer may reflect the increased cell proliferation, with a decrease in this peak after treatment reflecting decreased viability of the tumor. With further development and the assessment of Cho quantity in the tumor, breast MR spectroscopy may be helpful in the elucidation of the biology of breast cancer.
乳腺磁共振成像（MRI）已成为一种高度敏感的检查方式。除了从对比增强乳腺MRI获得形态学和动力学分析外，乳腺疾病的诊断还需要功能信息。乳腺活体质子（氢1 [（1）H]）磁共振波谱显示，乳腺癌中可检测到胆碱（Cho），而正常乳腺组织中一般检测不到Cho。因此，乳腺磁共振波谱作为区分良性和恶性病变以及评估局部晚期乳腺癌患者化疗药物疗效的一种方法，已显示出巨大的前景。此前在1.5-T MRI上进行的研究报告称，乳腺磁共振波谱的敏感性为70-100%（平均89%；149/168），特异性为67-100%（平均87%；97/112）。此外，乳腺癌中Cho峰的存在可能反映细胞增殖增加，治疗后该峰降低反映肿瘤活力下降。随着进一步发展以及对肿瘤中Cho含量的评估，乳腺磁共振波谱可能有助于阐明乳腺癌的生物学特性。
