Roebuck J R, Cecil K M, Schnall M D, Lenkinski R E
Department of Radiology, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA.
Radiology. 1998 Oct;209(1):269-75. doi: 10.1148/radiology.209.1.9769842.
To assess the clinical usefulness of spatially localized hydrogen-1 magnetic resonance (MR) spectroscopy in distinguishing benign from malignant lesions on the basis of total choline levels.
These studies were performed at 1.5 T with a four-channel multicoil that compresses the breast sagittally. Contrast material-enhanced MR imaging and single-voxel H-1 MR spectroscopy were performed in 17 patients (age range, 25-68 years) who had nonspecific mammographic findings. Histopathologic correlations were made from biopsy or surgical specimens. Ten patients had various malignant breast lesions 1-4 cm in diameter, and seven patients had benign processes.
Most studies were performed with nominal voxel sizes (< 2 cm3). Spectra obtained with an echo time of 31 msec showed resonances from water and mobile fatty acids and, in some cases, the N-trimethyl resonance of choline-containing compounds (Cho) at 3.2 ppm. The absolute concentration of Cho in each lesion was determined with a phantom containing 1 mmol/L Cho as an external reference. On the basis of reference measurements, the least detectable level of Cho was 0.2 mmol/L. With this threshold, seven of 10 malignant lesions showed detectable levels of Cho. In contrast, Cho was seen in only one patient with an extremely rare benign process, a tubular adenoma. The remaining six patients with benign processes demonstrated no detectable Cho levels.
Spatially localized H-1 MR spectroscopy can provide sufficient sensitivity and spectral resolution at 1.5 T to demonstrate Cho in human breast lesions with a spectroscopic protocol that provides up to 1-cm3 resolution. Determining the presence of Cho may provide a useful test for malignancy.
基于总胆碱水平，评估空间定位氢-1磁共振（MR）波谱在鉴别乳腺良恶性病变中的临床应用价值。
这些研究在1.5T磁共振成像仪上进行，使用四通道多线圈对乳腺进行矢状面压缩。对17例（年龄范围25 - 68岁）乳腺钼靶检查结果不明确的患者进行了对比剂增强MR成像和单体素H-1 MR波谱分析。通过活检或手术标本进行组织病理学对照。10例患者患有直径1 - 4cm的各种恶性乳腺病变，7例患者为良性病变。
大多数研究采用标称体素大小（<2cm³）。回波时间为31毫秒时获得的波谱显示了水和流动脂肪酸的共振信号，在某些情况下，还显示了3.2ppm处含胆碱化合物（Cho）的N-三甲基共振信号。每个病变中Cho的绝对浓度通过含有1mmol/L Cho的模型作为外部参考来确定。根据参考测量，Cho的最低可检测水平为0.2mmol/L。以此阈值为标准，10例恶性病变中有7例显示可检测到的Cho水平。相比之下，仅1例患有极为罕见的良性病变（管状腺瘤）的患者检测到Cho。其余6例良性病变患者未检测到Cho水平。
空间定位H-1 MR波谱在1.5T时可提供足够的灵敏度和波谱分辨率，以在高达1cm³分辨率的波谱分析方案下显示人类乳腺病变中的Cho。确定Cho的存在可能为恶性肿瘤提供一种有用的检测方法。
