Elevated tissue sodium concentration in malignant breast lesions detected with non-invasive 23Na MRI
Elevated tissue sodium concentration in malignant breast lesions detected with non-invasive 23Na MRI
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DOI：
10.1007/s10549-006-9485-4
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发表时间：
2007-12-01
影响因子：
3.8
通讯作者：
Bottomley, Paul A.
中科院分区：
文献类型：
--
作者：
Ouwerkerk, Ronald;Jacobs, Michael A.;Bottomley, Paul A.
背景采用无创、定量钠（Na-23）磁共振成像（MRI）技术对乳腺良恶性肿瘤患者进行无创、定量钠（Na-23）磁共振成像（MRI），验证恶性肿瘤增殖相关的生理生化变化可能导致组织总钠浓度（TSC）升高的假设。方法对22例乳腺可疑病变（1 cm）患者在1.5 Tesla下行Na-23和H-1 MRI检查。在同一次MRI检查中，使用商用质子（H-1）相控阵乳房线圈和定制螺线管Na-23线圈获取H-1和Na-23图像。定量三维Na-23投影成像在不到15分钟的时间内完成，MRI松弛或射频场不均匀造成的信号损失可以忽略不计。在H-1 MRI增强和解剖的基础上，共同登记的H-1和Na-23图像允许对正常和可疑组织的TSC进行量化，并通过活检证实组织学。结果（N = 19）组织学证实的恶性乳腺病变中钠浓度持续升高，与腺组织相比平均升高63%。与未受影响的腺组织（P < 0.0001，配对t检验）、脂肪组织和3例良性病变患者的TSC相比，恶性组织中钠浓度的升高非常显著。结论无创Na-23 MRI检测的乳腺病变中TSC升高可能是与恶性肿瘤相关的细胞水平指标。这种方法可能有潜力提高乳房MRI的特异性，仅适度增加每位患者的扫描时间。
Background The hypothesis that physiological and biochemical changes associated with proliferating malignant tumors may cause an increase in total tissue sodium concentration ( TSC) was tested with noninvasive, quantitative sodium ( Na-23) magnetic resonance imaging (MRI) in patients with benign and malignant breast tumors.Methods Na-23 and H-1 MRI of the breast was performed on 22 women with suspicious breast lesions ( 1 cm) at 1.5 Tesla. A commercial proton ( H-1) phased array breast coil and custom solenoidal Na-23 coil were used to acquire H-1 and Na-23 images during the same MRI examination. Quantitative 3-dimensional Na-23 projection imaging was implemented with negligible signal loss from MRI relaxation, or from radio-frequency field inhomogeneity, in less than 15 min. Co-registered H-1 and Na-23 images permitted quantification of TSC in normal and suspicious tissues on the basis of H-1 MRI contrast enhancement and anatomy, with histology confirmed by biopsy.Results Sodium concentrations were consistently elevated in ( N = 19) histologically proven malignant breast lesions by an average of 63% compared to glandular tissue. The increase in sodium concentration in malignant tissue was highly significant compared to unaffected glandular tissue ( P < 0.0001, paired t- test), adipose tissue, and TSC in three patients with benign lesions. Conclusion Elevated TSC in breast lesions measured by non- invasive Na-23 MRI appears to be a cellular-level indicator associated with malignancy. This method may have potential to improve the specificity of breast MRI with only a modest increase in scan time per patient.