Pharmacokinetic Analysis of Gd‐DTPA Enhancement in dynamic three‐dimensional MRI of breast lesions
Pharmacokinetic Analysis of Gd‐DTPA Enhancement in dynamic three‐dimensional MRI of breast lesions
复制标题
Gd-DTPA增强乳腺病变动态三维MRI的药代动力学分析
DOI：
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发表时间：
1997
影响因子：
4.4
通讯作者：
Rob A. I. De Vos
中科院分区：
文献类型：
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作者：
J. A. den Boer;Ruud K. K. M. Hoenderop;J. Smink;G. Dornseiffen;P. Koch;J. Mulder;C. Slump;E. Volker;Rob A. I. De Vos
本研究的目的是证明动态MRI覆盖双侧乳房可以提供肿瘤检测的灵敏度以及肿瘤恶性鉴别的特异性和灵敏度。使用三维梯度回波扫描覆盖双侧乳房。在Gd-DTPA团注前，以不同的翻转角获得两次扫描，注射后，随后进行动态系列扫描。根据本方案对32名患者进行了扫描。从这些扫描中，除了增强之外，还获得了注射前的T1值。这用于估计Gd-DTPA的浓度以及控制其时间过程的药代动力学参数。三维动态扫描中的信号增强被证明是检测肿瘤的敏感基础。在我们的系列中，除了两个乳房摄影可疑病灶外，所有病灶都增强了，在三个病例中，发现了额外的增强病灶，其中两个位于对侧乳房。最适合于乳腺病变分类为良性或恶性的参数被证明是药代动力学定义的渗透率k31，其中，对于该测试，给出了92%的灵敏度和70%的特异性。我们的三维动态MRI数据对于检测乳腺X线检查的隐匿性乳腺肿瘤是敏感的，并且对于将这些肿瘤分类为良性或恶性是特异性的。
The purpose of this study was to demonstrate that dynamic MRI covering both breasts can provide sensitivity for tumor detection as well as specificity and sensitivity for differentiation of tumor malignancy. Three‐dimensional gradient echo scans were used covering both breasts. Before Gd‐DTPA bolus injection, two scans were obtained with different flip angles, and after injection, a dynamic series followed. Thirty‐two patients were scanned according to this protocol. From these scans, in addition to enhancement, the value of T1 before injection was obtained. This was used to estimate the concentration of Gd‐DTPA as well as the pharmacokinetic parameters governing its time course. Signal enhancement in three‐dimensional dynamic scanning was shown to be a sensitive basis for detection of tumors. In our series, all but two mam‐mographically suspicious lesions did enhance, and in three cases, additional enhancing lesions were found, two of which were in the contralateral breast. The parameter most suited for classification of breast lesions into benign or malignant was shown to be the pharmacokinetically defined permeability k31, which, for that test, gave a sensitivity of 92% and a specificity of 70%. Our three‐dimensional dynamic MRI data are sensitive for detection of mammographically occult breast tumors and specific for classification of these as benign or malignant.