Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University Jena, Erlanger Allee 101, D-07740 Jena, Germany.
Eur J Radiol. 2012 Jul;81(7):1500-3. doi: 10.1016/j.ejrad.2011.03.001. Epub 2011 Apr 9.
Perifocal edema, defined as high T2w signal intensity around an enhancing lesion has been described as a specific feature of malignancy. In clinical MR-mammography (MRM), both fatsat and non-fatsat T2w sequences are available. However, there is no consensus on which technique should be used for edema assessment. Consequently, this investigation was performed to compare two commonly used pulse sequences for edema assessment in MRM.
321 consecutive patients from a 22 month period were included in this investigation. Further selection criteria were histopathological verification of enhancing lesions and absence of presurgical chemotherapy or biopsy, resulting in 108 malignant and 107 benign lesions. All underwent MRM according to international guidelines including a non-fatsat T2w-TSE sequence (TR/TE: 8900/207 ms) and a short tau inversion recovery fatsat sequence (STIR, TR/TE: 8420/70 ms). All images were acquired in the same orientation (axial) and slice thickness. Two experienced radiologists in consensus rated presence of perifocal edema according to an ordinal scale: 0 = not present, 1 = little, 2 = intermediate, and 3 = distinct. Data analysis was performed using crosstabs and Visual Grading Characteristics (VGC) analysis.
Overall sensitivity/specificity was calculated with 53.7%/94.4% (T2w-TSE) and 52.8%/95.3% (STIR). VGC revealed an area under the VGC curve of 0.502 (standard error 0.026), P = 0.814.
Perifocal edema is a specific feature of malignancy with moderate sensitivity. VGC analysis did not reveal significant differences between both pulse sequences analysed. Consequently, both T2w-TSE and STIR images are suitable for assessment of perifocal edema.
瘤周水肿定义为强化病变周围的高 T2w 信号强度，已被描述为恶性肿瘤的特征之一。在临床磁共振乳腺成像（MRM）中，既有脂肪饱和和非脂肪饱和 T2w 序列。然而，对于哪种技术用于评估水肿尚未达成共识。因此，本研究旨在比较两种常用于 MRM 评估水肿的常用脉冲序列。
本研究纳入了 22 个月期间的 321 例连续患者。进一步的选择标准是增强病变的组织病理学验证以及无术前化疗或活检，最终纳入 108 例恶性病变和 107 例良性病变。所有患者均根据国际指南进行了 MRM 检查，包括非脂肪饱和 T2w-TSE 序列（TR/TE：8900/207ms）和短 tau 反转恢复脂肪饱和序列（STIR，TR/TE：8420/70ms）。所有图像均在相同方位（轴位）和切片厚度下采集。两位有经验的放射科医生根据有序量表一致评估瘤周水肿的存在：0=不存在，1=轻度，2=中度，3=明显。使用交叉表和视觉分级特征（VGC）分析进行数据分析。
总体灵敏度/特异性分别为 53.7%/94.4%（T2w-TSE）和 52.8%/95.3%（STIR）。VGC 显示 VGC 曲线下面积为 0.502（标准误差 0.026），P=0.814。
瘤周水肿是恶性肿瘤的特征之一，具有中等敏感性。VGC 分析未显示分析的两种脉冲序列之间存在显著差异。因此，T2w-TSE 和 STIR 图像均适用于评估瘤周水肿。
