对比增强前后乳腺良恶性病变的扩散加权磁共振成像
Diffusion-weighted MR imaging of benign and malignant breast lesions before and after contrast enhancement.
作者信息
Janka R, Hammon M, Geppert C, Nothhelfer A, Uder M, Wenkel E
机构信息
Department of Radiology, University Hospital Erlangen.
Healthcare Sector, Siemens AG, Erlangen.
出版信息
Rofo. 2014 Feb;186(2):130-5. doi: 10.1055/s-0033-1350298. Epub 2013 Aug 8.
PURPOSE
Many publications describe the use of diffusion-weighted imaging (DWI) in breast MRI. This article addresses the question of when to apply the DWI sequence in the course of the scan protocol. The effect of T1-shortening contrast media (CM) on the ADC values of breast lesions is investigated.
MATERIALS AND METHODS
Data were acquired on a 1.5 T scanner. 60 patients with 79 lesions (20 benign, 59 malignant) were included. The DWI sequence (4 mm slice thickness, b-values: 50, 400, 800) was applied before and after CM administration. Before calculating the ADC map, the b50, b400 and b800 series were analyzed concerning lesion displacement. ADC values before and after CM application were compared.
RESULTS
The mean lesion size was 1.5 ± 0.8 cm. On the basis of the b50 and b400 measurements, the mean ADC value of benign lesions was 1.89 ± 0.30 × 10-3 mm2/s before and 1.85 ± 0.28 ×10-3 mm2/s after CM administration. The consecutive values for two pure mucinous carcinomas were 1.88 × 10-3 mm2/s and 1.81 × 103 mm2/s and for the remaining malignant lesions 1.00 ± 0.18 × 10-3 mm2/s and 0.88 ± 0.21 × 10-3 mm2. On the basis of the b50, b400 and b800 measurements, the mean ADC value of benign lesions was 1.99 ± 0.37 × 10-3 mm2/s before and 1.97 ± 0.30 × 10-3 mm2/s after CM application, whereas the mean ADC value of the malignant lesions was 0.90 ± 0.14 × 10-3 mm2/s before and 0.80 ± 0.14 × 10-3 mm2/s after CM application. While there was no significant change for benign lesions, the ADC value decrease in post-contrast malignant lesions was highly significant.
CONCLUSION
DWI after CM is possible and even leads to slightly better lesion discrimination between benign and malignant. However, further studies need to be performed to verify this. Citation Format: • Janka R, Hammon M, Geppert C et al. Diffusion-Weighted MR Imaging of Benign and Malignant Breast Lesions Before and After Contrast Enhancement. Fortschr Röntgenstr 2014; 186: 130 - 135.
目的
许多出版物描述了扩散加权成像（DWI）在乳腺磁共振成像（MRI）中的应用。本文探讨了在扫描协议过程中何时应用DWI序列的问题。研究了T1缩短造影剂（CM）对乳腺病变表观扩散系数（ADC）值的影响。
材料与方法
在1.5T扫描仪上采集数据。纳入60例患者的79个病变（20个良性，59个恶性）。在注射CM前后应用DWI序列（层厚4mm，b值：50、400、800）。在计算ADC图之前，分析b50、b400和b800系列的病变移位情况。比较注射CM前后的ADC值。
结果
病变平均大小为1.5±0.8cm。根据b50和b400测量，良性病变的平均ADC值在注射CM前为1.89±0.30×10⁻³mm²/s，注射后为1.85±0.28×10⁻³mm²/s。两个纯黏液腺癌的连续值分别为1.88×10⁻³mm²/s和1.81×10³mm²/s，其余恶性病变为1.00±0.18×10⁻³mm²/s和0.88±0.21×10⁻³mm²。根据b50、b400和b800测量，良性病变的平均ADC值在注射CM前为1.99±0.37×10⁻³mm²/s，注射后为1.97±0.30×10⁻³mm²/s，而恶性病变的平均ADC值在注射CM前为0.90±0.14×10⁻³mm²/s，注射后为0.80±0.14×10⁻³mm²/s。良性病变无显著变化，而增强后恶性病变的ADC值下降非常显著。
结论
注射CM后进行DWI是可行的，甚至能在一定程度上更好地区分良性和恶性病变。然而，需要进一步研究来验证这一点。引用格式：• 扬卡R，哈蒙M，格佩特C等。对比增强前后乳腺良恶性病变的扩散加权磁共振成像。《Fortschr Röntgenstr》2014年；186：130 - 135。
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