Dynamic NMR effects in breast cancer dynamic-contrast-enhanced MRI
Dynamic NMR effects in breast cancer dynamic-contrast-enhanced MRI
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DOI：
10.1073/pnas.0804224105
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发表时间：
2008-11-18
影响因子：
11.1
通讯作者：
Springer, Charles S., Jr.
中科院分区：
文献类型：
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作者：
Li, Xin;Huang, Wei;Springer, Charles S., Jr.
血管注射顺磁对比剂（CR）丸通过感兴趣区域会影响组织(H2O)-H-1松弛，从而影响MR图像强度。对于纵向弛豫[R-1等效于（T-1）（-1）]， CR必须与水发生瞬态分子相互作用。由于CR和水分子在组织学尺度的组织间室中从未均匀分布，平衡水间室交换的动力学是竞争性的。特别是，经细胞膜水交换核磁共振系统的平衡条件随着间隙CR浓度[CRo]的变化而变化。CR之前，系统处于快速交换限制（FXL）状态。在CRo到达后不久，它就进入了快速兑换制度（FXR）。在接近最大CRo时，系统甚至可以进入慢交换机制（SXR）。本文定义了这些条件，并对它们如何影响定量药代动力学分析进行了全面描述。数据分析来自22名最初被筛查为乳腺癌的患者。在参与我们的研究后，受试者进行了活检/病理检查，只有7例（32%）被发现有恶性肿瘤。从FXL到FXR的短暂偏离（显然不是SXR）仅在恶性肿瘤中是显著的，可能是因为血管生成毛细血管渗漏。因此，如果被接受，这一分析将阻止68%的活检被证明是良性的。
The passage of a vascular-injected paramagnetic contrast reagent (CR) bolus through a region-of-interest affects tissue (H2O)-H-1 relaxation and thus MR image intensity. For longitudinal relaxation [R-1 equivalent to (T-1)(-1)], the CR must have transient molecular interactions with water. Because the CR and water molecules are never uniformly distributed in the histological-scale tissue compartments, the kinetics of equilibrium water compartmental interchange are competitive. In particular, the condition of the equilibrium transcytolemmal water exchange NMR system sorties through different domains as the interstitial CR concentration, [CRo], waxes and wanes. Before CR, the system is in the fast-exchange-limit (FXL). Very soon after CRo arrival, it enters the fast-exchange-regime (FXR). Near maximal [CRo], the system could enter even the slow-exchange-regime (SXR). These conditions are defined herein, and a comprehensive description of how they affect quantitative pharmacokinetic analyses is presented. Data are analyzed from a population of 22 patients initially screened suspicious for breast cancer. After participating in our study, the subjects underwent biopsy/pathology procedures and only 7 (32%) were found to have malignancies. The transient departure from FXL to FXR (and apparently not SXR) is significant in only the malignant tumors, presumably because of angiogenic capillary leakiness. Thus, if accepted, this analysis would have prevented the 68% of the biopsies that proved benign.