Kvistad K A, Lundgren S, Fjøsne H E, Smenes E, Smethurst H B, Haraldseth O
MR-Center, University Hospital, Trondheim, Norway.
Acta Radiol. 1999 Jan;40(1):45-51. doi: 10.1080/02841859909174402.
Invasive breast carcinomas and fibroadenomas are often difficult to differentiate in dynamic contrast-enhanced T1-weighted MR imaging of the breast, because both tumors can enhance strongly after contrast injection. The purpose of this study was to evaluate whether the addition of T2*-weighted first pass perfusion imaging can increase the differentiation of malignant from benign lesions.
Nine patients with invasive carcinomas and 10 patients with contrast enhancing fibroadenomas were examined by a dynamic contrast-enhanced T1-weighted 3D sequence immediately followed by a single slice T2*-weighted first pass perfusion sequence positioned in the contrast-enhancing lesion.
The carcinomas and the fibroadenomas were impossible to differentiate based on the contrast enhancement characteristics in the T1-weighted sequence. The signal loss in the T2*-weighted perfusion sequence was significantly stronger in the carcinomas than in the fibroadenomas (p = 0.0004).
Addition of a T2*-weighted first pass perfusion sequence with a high temporal resolution can probably increase the differentiation of fibroadenomas from invasive carcinomas in contrast-enhanced MR imaging of the breast.
在乳腺动态对比增强T1加权磁共振成像中，浸润性乳腺癌和纤维腺瘤常常难以鉴别，因为两种肿瘤在注射对比剂后均可出现明显强化。本研究的目的是评估增加T2*加权首过灌注成像是否能提高良恶性病变的鉴别能力。
对9例浸润性癌患者和10例对比增强纤维腺瘤患者先采用动态对比增强T1加权3D序列进行检查，随后对增强病变所在层面采用单层T2*加权首过灌注序列进行检查。
根据T1加权序列中的对比增强特征无法鉴别癌和纤维腺瘤。癌在T2*加权灌注序列中的信号丢失明显强于纤维腺瘤（p = 0.0004）。
在乳腺对比增强磁共振成像中，增加具有高时间分辨率的T2*加权首过灌注序列可能会提高纤维腺瘤与浸润性癌的鉴别能力。
