Department of Radiology, MR Center of Excellence and Division of Molecular and Gender Imaging, Medical University of Vienna, Lazarettgasse 14, A-1090 Vienna, Austria.
Radiology. 2011 Dec;261(3):752-61. doi: 10.1148/radiol.11102096. Epub 2011 Oct 13.
To evaluate the diagnostic accuracy of quantitative, three-dimensional (3D) magnetic resonance (MR) spectroscopic imaging at 3 T for the differentiation of benign and malignant breast lesions, on the basis of choline (Cho) signal-to-noise ratio (SNR) threshold levels, in a clinically feasible measurement time.
Institutional review board approval and written informed consent were obtained from all subjects. Fifty female patients (mean age, 50 years; age range, 25-82 years) with mammographic or ultrasonographic (US) abnormalities were successfully examined in the prone position with a 3-T MR system by using a dedicated breast coil. Lesions were verified by either histopathologic examination or follow-up of at least 24 months. For 3D MR spectroscopic imaging, a point-resolved spectroscopic sequence (repetition time msec/echo time msec, 750/145; field of view, 12 × 12 × 12 cm(3); matrix size, 12 × 12 × 12, interpolated to 16 × 16 × 16; acquisition time, 11 minutes 17 seconds) was used. The maximum Cho SNR was assessed in all lesions and correlated with the histopathologic results.
Thirty-two malignant and 12 benign lesions were confirmed in 43 patients with histopathologic examination. Seven patients without biopsy underwent imaging follow-up. In 31 of 32 (97%) malignant and 10 of 19 (53%) benign lesions, Cho was detected. The median Cho SNR in malignant lesions was 5.7, compared with 2.0 in benign lesions. With a Cho SNR threshold level of 2.6, 3D MR spectroscopic imaging provided a sensitivity of 97% and a specificity of 84% for the differentiation of benign and malignant breast lesions.
At 3T, 3D MR spectroscopic imaging yields high diagnostic sensitivity and specificity for discrimination of benign and malignant breast lesions within reasonable measurement times. This technique allows the study of heterogeneous and multicentric breast tumors and simplifies acquisition planning.
基于胆碱（Cho）信号与噪声比（SNR）阈值水平，在临床可行的测量时间内，评估 3T 下定量、三维（3D）磁共振（MR）波谱成像在区分乳腺良恶性病变中的诊断准确性。
本研究获得了所有研究对象的机构审查委员会批准和书面知情同意。50 例女性患者（平均年龄，50 岁；年龄范围，25-82 岁）接受了乳腺专用线圈的 3T MR 系统的俯卧位检查。病变通过组织病理学检查或至少 24 个月的随访得到证实。3D MR 波谱成像采用点分辨波谱序列（重复时间毫秒/回波时间毫秒，750/145；视野，12×12×12cm3；矩阵大小，12×12×12，插值至 16×16×16；采集时间，11 分 17 秒）。在所有病变中评估最大 Cho SNR，并与组织病理学结果相关联。
在 43 例经组织病理学检查证实的患者中，32 例为恶性，12 例为良性病变。7 例未行活检的患者进行了影像学随访。在 32 例恶性病变中的 31 例（97%）和 19 例良性病变中的 10 例（53%）中检测到 Cho。恶性病变的中位数 Cho SNR 为 5.7，良性病变为 2.0。Cho SNR 阈值为 2.6 时，3D MR 波谱成像对区分乳腺良恶性病变的敏感性为 97%，特异性为 84%。
在 3T 下，3D MR 波谱成像在合理的测量时间内对区分乳腺良恶性病变具有较高的诊断敏感性和特异性。该技术允许对异质性和多中心乳腺肿瘤进行研究，并简化采集计划。
