Wenkel E, Uder M, Janka R
Radiologisches Institut, Universitätsklinikum Erlangen, Maximiliansplatz 1, 91054, Erlangen, Deutschland,
Radiologe. 2014 Mar;54(3):224-32. doi: 10.1007/s00117-013-2588-0.
Diffusion-weighted imaging (DWI) of the breast provides additional contrast information in breast magnetic resonance imaging (MRI). The DWI procedure can easily be implemented in the routine breast MRI protocol with little time expenditure regarding image acquisition and evaluation. Evaluation of the DW images can be performed with or without the routine breast MRI sequences (T2w and T1w with contrast material) but evaluation in combination with the routine program is highly recommended. Objective analysis of the tissue diffusion can be achieved by calculating the apparent diffusion coefficient (ADC) value with the scanner software. The choice of the DW sequence, evaluation and determination of the ADC threshold to differentiate between benign and malignant lesions should be scanner adapted. The use of DW imaging qualifies for routine use regarding the differentiation between malignant and benign breast lesions. Non-mass-like lesions and monitoring neoadjuvant chemotherapy can also be evaluated with DW sequences. The benefit of the additional information from DW-MR mammography to characterize non-mass-like lesions and in the course of neoadjuvant chemotherapy remains unclear to date.
乳腺扩散加权成像（DWI）在乳腺磁共振成像（MRI）中提供了额外的对比信息。DWI程序可以很容易地在常规乳腺MRI协议中实施，在图像采集和评估方面几乎不花费时间。DW图像的评估可以在有或没有常规乳腺MRI序列（T2加权和T1加权对比剂增强序列）的情况下进行，但强烈建议与常规程序联合评估。通过使用扫描仪软件计算表观扩散系数（ADC）值，可以实现对组织扩散的客观分析。DW序列的选择、评估以及区分良性和恶性病变的ADC阈值的确定应根据扫描仪进行调整。DW成像在鉴别乳腺良恶性病变方面符合常规使用标准。非肿块样病变以及新辅助化疗的监测也可以通过DW序列进行评估。迄今为止，DW-MR乳腺摄影所提供的额外信息在鉴别非肿块样病变以及新辅助化疗过程中的作用仍不明确。
