Detection of breast malignancy: Diagnostic MR protocol for improved specificity
Detection of breast malignancy: Diagnostic MR protocol for improved specificity
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DOI：
10.1148/radiol.2322030547
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发表时间：
2004-08-01
期刊：
影响因子：
19.7
通讯作者：
Button, TM
中科院分区：
文献类型：
--
作者：
Huang, W;Fisher, PR;Button, TM
目得：为了前瞻性地确定包括T1加权动态对比剂增强（DCE）MR成像、氢1（H-1）MR波谱和T2* 加权灌注MR成像的联合磁共振（MR）方案是否提高了乳腺癌诊断的特异性。材料和方法：在乳腺X线检查阳性结果后但活检前，对50例患者进行了联合MR成像-MR波谱检查。只有当DCE MR图像显示病变快速对比增强时，才进行单体素质子MR波谱和灌注MR成像。活检结果与MR结果进行比较，计算乳腺恶性肿瘤检出的敏感性和特异性。结果：单独使用DCE MR成像的敏感性为100%，特异性为62.5%。特异性提高到87.5%，增加了H-1磁共振波谱和100%，进一步增加灌注磁共振成像。28例患者同时接受了MR波谱和灌注MR成像。2例患者接受了MR波谱分析，但拒绝接受灌注MR成像。结论：DCE MR成像、H-1 MR波谱和灌注MR成像联合应用对乳腺癌的诊断具有较高的敏感性和特异性。(C)RSNA 2004年。
PURPOSE: To prospectively determine if a combined magnetic resonance (MR) protocol that includes T1-weighted dynamic contrast agent-enhanced (DCE) MR imaging, hydrogen 1 (H-1) MR spectroscopy, and T2*-weighted per-fusion MR imaging improves specificity in the diagnosis of breast cancer.MATERIALS AND METHODS: The combined MR imaging-MR spectroscopy protocol was performed in 50 patients after positive findings at mammography but prior to biopsy. Single-voxel proton MR spectroscopy and perfusion MR imaging were conducted only if DCE MR images showed rapid contrast enhancement in the lesion. Biopsy results were used as the reference for comparison with MR results and for calculation of sensitivity and specificity in the detection of breast malignancy.RESULTS: DCE MR imaging alone showed 100% sensitivity and 62.5% specificity. The specificity improved to 87.5% with the addition of H-1 MR spectroscopy and to 100% with the further addition of perfusion MR imaging. Twenty-eight patients underwent both MR spectroscopy and perfusion MR imaging. Two patients underwent MR spectroscopy but declined to undergo perfusion MR imaging. The remaining 20 patients had negative results at DCE MR imaging and therefore did not undergo the additional examinationsCONCLUSION: The combined MR protocol of DCE MR imaging, H-1 MR spectroscopy, and perfusion MR imaging has high sensitivity and specificity in the diagnosis of breast cancer. (C) RSNA 2004.