Koshiishi T, Isomoto I, Nakamura K, Kajiwara Y, Izawa K
Department of Radiology, Saga National Hospital.
Nihon Igaku Hoshasen Gakkai Zasshi. 1998 Jul;58(8):433-40.
To assess the value and problems of fat-suppressed dynamic MR imaging in differentiating between benign and malignant lesions.
In twenty-nine patients who underwent excisional biopsy or surgical resection, fat-suppressed dynamic MR imaging was performed with a 0.5 T superconducting magnet. Pre-and postcontrast 3D-spoiled gradient echo sequences were employed with fat suppression. We calculated and evaluated the contrast-to-noise ratio (CNR) and contrast enhancement ratio (CER) at each contrast determination time (CDT), which is the intermediate time in the scan.
Time intensity curves of CNR showed no statistically significant difference between cancers and other benign lesions. The difference in CER between malignant and benign disease was highly significant (P = .006) at CDT 45 sec., but there was great overlap in the time intensity curve of CER after CDT 45 sec.
When we attempt to differentiate malignant from benign breast lesions by dynamic MR imaging, comparison of CNR is impertinent, and we should evaluate the differential diagnosis of cancer versus benign lesions by means of CER at CDT points of about 45 sec.
评估脂肪抑制动态磁共振成像在鉴别乳腺良恶性病变中的价值及存在的问题。
对29例行切除活检或手术切除的患者,采用0.5T超导磁共振仪行脂肪抑制动态磁共振成像。运用脂肪抑制的三维扰相梯度回波序列进行对比剂增强前后的扫描。在扫描的中间时间点即每个对比剂测定时间(CDT)计算并评估对比噪声比(CNR)和对比增强率(CER)。
CNR的时间-强度曲线在癌灶与其他良性病变之间无统计学显著差异。在CDT 45秒时,恶性与良性疾病的CER差异高度显著(P = 0.006),但在CDT 45秒后CER的时间-强度曲线有很大重叠。
当试图通过动态磁共振成像鉴别乳腺良恶性病变时,比较CNR是不相关的,我们应在约45秒的CDT时间点通过CER评估癌灶与良性病变的鉴别诊断。