Rubens D, Totterman S, Chacko A K, Kothari K, Logan-Young W, Szumowski J, Simon J H, Zachariah E
Department of Radiology, University of Rochester School of Medicine and Dentistry, NY 14642.
AJR Am J Roentgenol. 1991 Aug;157(2):267-70. doi: 10.2214/ajr.157.2.1853803.
Standard T1-weighted MR images enhanced with gadopentetate dimeglumine show relatively minimal enhancement of breast lesions due to the high background signal from fat in the breast. Strongly enhancing lesions may become isointense relative to the fat signal and become invisible or indistinct after contrast administration. Fat-suppressed chemical-shift imaging (CSI) combined with administration of gadopentetate dimeglumine improves lesion detection and characterization in other areas of the body where a strong lipid signal is present. We evaluated this technique in the breast. Twenty patients with mammographic lesions were studied with standard unenhanced T1- and T2-weighted images and enhanced T1-weighted images, as well as with CSI before and after administration of gadopentetate dimeglumine. The series were ranked independently for border and matrix characteristics. The border was assessed for a smooth, irregular, or spiculated margin. The matrix or internal substance was evaluated for visibility and type of enhancement, homogeneous or inhomogeneous. The enhanced CSI images were superior to all other images in the depiction of border and matrix characteristics. Of 20 patients, a corresponding mass was detected on MR in 14. In two of the 14 patients, the lesion was seen only in the enhanced CSI images. Chemical-shift artifacts on enhanced T1-weighted images obscured border detail in several cases. Enhanced CSI improves visualization of breast lesions as compared with conventional MR imaging with or without enhancement. The enhanced CSI technique produces differential enhancement between glandular tissue and lesions while suppressing the signal from fat. This improves the visualization of border and matrix characteristics and depicts lesions that otherwise might be obscured.
用钆喷酸葡胺增强的标准T1加权磁共振成像显示，由于乳腺中脂肪的高背景信号，乳腺病变的增强相对较少。强化明显的病变在注射造影剂后相对于脂肪信号可能变为等信号，变得不可见或不清晰。脂肪抑制化学位移成像（CSI）结合钆喷酸葡胺的使用，可改善身体其他存在强脂质信号区域的病变检测和特征描述。我们在乳腺中评估了这项技术。对20例有乳腺X线摄影病变的患者进行了研究，采用标准的未增强T1加权和T2加权图像、增强T1加权图像，以及注射钆喷酸葡胺前后的CSI。对各序列的边界和基质特征进行独立分级。评估边界的边缘是光滑、不规则还是毛刺状。评估基质或内部物质的可见性和强化类型，是均匀强化还是不均匀强化。增强的CSI图像在显示边界和基质特征方面优于所有其他图像。20例患者中，14例在磁共振成像上检测到相应肿块。在这14例患者中的2例中，病变仅在增强的CSI图像中可见。增强T1加权图像上的化学位移伪影在一些病例中掩盖了边界细节。与有或无增强的传统磁共振成像相比，增强CSI改善了乳腺病变的可视化。增强CSI技术在抑制脂肪信号的同时，使腺体组织和病变之间产生差异强化。这改善了边界和基质特征的可视化，并显示出否则可能被掩盖的病变。
