Diffusion-weighted MR for Differentiation of Breast Lesions at 3.0 T: How Does Selection of Diffusion Protocols Affect Diagnosis?
Diffusion-weighted MR for Differentiation of Breast Lesions at 3.0 T: How Does Selection of Diffusion Protocols Affect Diagnosis?
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DOI：
10.1148/radiol.2532081718
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发表时间：
2009-11-01
期刊：
影响因子：
19.7
通讯作者：
Trattnig, Siegfried
中科院分区：
文献类型：
--
作者：
Bogner, Wolfgang;Gruber, Stephan;Trattnig, Siegfried
目的：比较扩散加权（DW）成像方案的诊断质量的表观扩散系数（ADC）的准确性，ADC精度，DW成像对比噪声比（CNR）为不同类型的病变和乳腺tissue.Materials和方法：机构审查委员会批准和书面知情同意书。本研究纳入了51例具有组织病理学相关性或使用3.0 T MR成像仪进行随访的患者。在24个恶性、17个良性、20个囊性和51个正常组织区域中绘制了112个感兴趣区域。计算10个B值组合的ADC图（范围，0-1250 sec/mm（2））。评估了不同组织类型之间ADC的差异。比较DW成像时病变的CNR的所有B值。重复测量方差分析用于评估病变分化。根据50和850 sec/mm（2）的B值计算的ADC为0.99 × 10（-3）mm（2）/sec +/- 0.18（标准差），恶性、良性、正常和囊性组织分别为1.47 × 10（-3）mm（2）/sec +/- 0.21、1.85 × 10（-3）mm（2）/sec +/- 0.22和2.64 × 10（-3）mm（2）/sec +/- 0.30。ADC阈值水平为1.25 × 10 - 3 mm 2/sec时，可区分恶性和良性病变，诊断准确率为95%（P <0.001）。使用多个B值进行的ADC计算并不比仅使用两个值进行的ADC计算更精确。我们发现ADC的最大值B值高达1000 sec/mm（2）。肿瘤的最佳CNR确定为850 sec/mm（2）。结论：采用50和850 sec/mm（2）的组合B值方案，可以在3.0 T下获得最佳ADC测定和DW成像质量。这为乳腺良恶性肿瘤的鉴别提供了较高的准确性。(C)RSNA，2009年
Purpose: To compare the diagnostic quality of diffusion-weighted (DW) imaging schemes with regard to apparent diffusion coefficient (ADC) accuracy, ADC precision, and DW imaging contrast-to-noise ratio (CNR) for different types of lesions and breast tissue.Materials and Methods: Institutional review board approval and written, informed consent were obtained. Fifty-one patients with histopathologic correlation or follow-up performed with a 3.0-T MR imager were included in this study. There were 112 regions of interest drawn in 24 malignant, 17 benign, 20 cystic, and 51 normal tissue regions. ADC maps were calculated for combinations of 10 b values (range, 0-1250 sec/mm(2)). Differences in ADC among tissue types were evaluated. The CNRs of lesions at DW imaging were compared for all b values. A repeated-measures analysis of variance was used to assess lesion differentiation.Results: ADCs calculated from b values of 50 and 850 sec/mm(2) were 0.99 X 10(-3) mm(2)/sec +/- 0.18 (standard deviation), 1.47 X 10(-3) mm(2)/sec +/- 0.21, 1.85 X 10(-3) mm(2)/sec +/- 0.22, and 2.64 X 10(-3) mm(2)/sec +/- 0.30 for malignant, benign, normal, and cystic tissues, respectively. An ADC threshold level of 1.25 X 10(-3) mm(2)/sec allowed discrimination between malignant and benign lesions with a diagnostic accuracy of 95% (P < .001). ADC calculations performed with multiple b values were not significantly more precise than those performed with only two. We found an overestimation of ADC for maximum b values of up to 1000 sec/mm(2). The best CNR for tumors was identified at 850 sec/mm(2).Conclusion: Optimum ADC determination and DW imaging quality at 3.0 T was found with a combined b value protocol of 50 and 850 sec/mm(2). This provided a high accuracy for differentiation of benign and malignant breast tumors. (C) RSNA, 2009