Kousi E, Tsougos I, Vasiou K, Theodorou K, Poultsidi A, Fezoulidis I, Kappas C
Medical Physics Department, University of Thessaly, Biopolis, 41110 Larissa, Greece.
ScientificWorldJournal. 2012;2012:754380. doi: 10.1100/2012/754380. Epub 2012 May 3.
To determine whether in vivo proton magnetic resonance spectroscopy at 3T can provide accurate breast lesion characterization, and to determine the effect of gadolinium on the resonance of tCho.
Twenty-four positive-mammogram patients were examined on a 3T MR scanner. 1H-MRS was performed before and after gadolinium administration. tCho peak was qualitatively evaluated before and after contrast injection.
Fourteen out of 27 lesions proved to be malignant after histopathological diagnosis. Using 1H-MRS, before contrast injection, 6/14 confirmed malignancies and 11/13 benign lesions were correctly classified; while, after contrast injection, 11/14 confirmed malignancies and 12/13 benign processes were correctly classified. Post gadolinium 1H-MRS proved useful in picking up tCho signal, improving the overall accuracy, sensitivity, and specificity by 35%, 83%, and 9%, respectively.
1H-MRS overall accuracy, sensitivity, and specificity in detecting breast lesion's malignancy were increased after gadolinium administration. It is prudent to perform 1H-MRS before contrast injection in large breast lesions to avoid choline underestimation. In cases of small or non-mass lesions, it is recommended to perform 1H-MRS after contrast injection for better voxel prescription to enable a reliable preoperative diagnosis.
确定3T磁共振成像（MRI）的体内质子磁共振波谱（MRS）是否能够准确地对乳腺病变进行特征性诊断，并确定钆对比剂对总胆碱（tCho）共振的影响。
对24例乳腺钼靶检查呈阳性的患者进行3T MR扫描。在注射钆对比剂前后分别进行氢质子磁共振波谱（1H-MRS）检查。在注射对比剂前后对tCho峰进行定性评估。
经组织病理学诊断，27个病变中有14个为恶性。使用1H-MRS检查，在注射对比剂前，14个确诊恶性病变中的6个以及13个良性病变中的11个被正确分类；而在注射对比剂后，14个确诊恶性病变中的11个以及13个良性病变中的12个被正确分类。钆剂增强后的1H-MRS检查有助于检测tCho信号，总体准确性、敏感性和特异性分别提高了35%、83%和9%。
注射钆对比剂后，1H-MRS在检测乳腺病变恶性程度方面的总体准确性、敏感性和特异性均有所提高。对于较大的乳腺病变，谨慎起见应在注射对比剂前进行1H-MRS检查，以避免胆碱信号被低估。对于较小的或非肿块性病变，建议在注射对比剂后进行1H-MRS检查，以便更好地确定体素，从而实现可靠的术前诊断。
