Yamaguchi Ken, Ichinohe Kanto, Iyadomi Mizuki, Fujiki Kazuya, Yoshinaga Yutaka, Egashira Ryoko, Nakazono Takahiko
Department of Radiology, Faculty of Medicine, Saga University, Saga, Saga, Japan.
Magn Reson Med Sci. 2025 Jul 1;24(3):315-331. doi: 10.2463/mrms.rev.2024-0158. Epub 2025 Mar 5.
The early detection and treatment of breast cancer is extremely important for extending patients' outcomes. Breast MRI has high sensitivity for the detection of breast cancer and plays an important role in breast cancer diagnosis and treatment, but conventional dynamic contrast-enhanced (DCE) MRI may be too time-consuming for breast cancer screening purposes. Abbreviated MRI is a technique that can be applied within a short time, as usually only the pre-contrast and first post-contrast images from the dynamic study or additional T2-weighted imaging are used. Abbreviated MRI may thus be suitable for breast cancer screening. In addition, its diagnostic performance for differentiating benign and malignant breast lesions is superior to that of breast tomosynthesis and comparable to that of conventional DCE MRI. The usefulness of abbreviated MRI for patients with a history of breast cancer and in clinical settings has been described, but the specificity of abbreviated DCE MRI is slightly lower than that of conventional DCE MRI. Ultrafast DCE MRI is a technique that obtains kinetic information by capturing multiple time phases in a short time scan in the very early phase after the injection of contrast material. Various parameters, including the maximum slope and time to enhancement can be used to evaluate kinetic information. Based on this kinetic information, ultrafast DCE MRI can differentiate between benign and malignant breast lesions. Since background parenchymal enhancement (BPE) is weak in the very early phase after a contrast media injection, ultrafast DCE MRI is also useful for identifying lesions in patients with marked BPE on conventional DCE MRI. In addition, ultrafast DCE MRI is useful for predicting the prognostic marker status of breast cancer, assessing the effectiveness of neoadjuvant therapy, examining MRI-detected lesions before surgery, and morphological assessments.
乳腺癌的早期检测和治疗对于延长患者的预后极为重要。乳腺磁共振成像（MRI）对乳腺癌检测具有高灵敏度，在乳腺癌的诊断和治疗中发挥着重要作用，但传统的动态对比增强（DCE）MRI用于乳腺癌筛查可能耗时过长。简化MRI是一种可在短时间内应用的技术，通常仅使用动态研究的对比前和首次对比后图像或额外的T2加权成像。因此，简化MRI可能适用于乳腺癌筛查。此外，其鉴别乳腺良恶性病变的诊断性能优于乳腺断层合成，与传统DCE MRI相当。简化MRI在有乳腺癌病史的患者和临床环境中的实用性已有描述，但简化DCE MRI的特异性略低于传统DCE MRI。超快DCE MRI是一种在注射造影剂后的极早期通过短时间扫描捕获多个时间相来获取动力学信息的技术。包括最大斜率和强化时间在内的各种参数可用于评估动力学信息。基于此动力学信息，超快DCE MRI可区分乳腺良恶性病变。由于在注射造影剂后的极早期背景实质强化（BPE）较弱，超快DCE MRI对于在传统DCE MRI上有明显BPE的患者识别病变也很有用。此外，超快DCE MRI对于预测乳腺癌的预后标志物状态、评估新辅助治疗的有效性、术前检查MRI检测到的病变以及形态学评估也很有用。
