比较乳腺高分辨率弥散加权成像中病变的明显性和 ADC 可靠性

Mami Iima, Rena Nakayama, Masako Kataoka, Martins Otikovs, Noam Nissan, Lucio Frydman, Yuta Urushibata, Maya Honda, Aika Okazawa, Hiroko Satake, Shinji Naganawa, Yuji Nakamoto
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引用次数: 0

摘要

目的:本研究调查了三种不同的弥散加权成像(DWI)方案:时空编码(SPEN)、单次回声平面成像(SS-EPI)和长可变回声序列读出分割(RESOLVE)的乳腺病变显着性和表观弥散系数(ADC)可靠性:本研究共纳入 65 名疑似患有乳腺肿瘤的女性,进一步分析了 44 个病灶(36 个恶性,8 个良性)。乳腺磁共振成像在 3 Tesla (3T) 系统(MAGNETOM Prisma,西门子)上进行,该系统配备了专用的 18 通道乳腺阵列线圈,用于模型和患者。使用了三种 DWI 方案--SPEN、SS-EPI 和 RESOLVE。SS-EPI 的面内分辨率为 2 × 2 mm2,切片厚度为 3 mm,b 值为 0 和 1000 s/mm2。SPEN 的平面内分辨率更高,为 1 × 1 平方毫米,切片厚度为 1.5 毫米,b 值为 0、850 和 1500 s/mm2。RESOLVE的平面内分辨率为1×1平方毫米,切片厚度为1.5毫米,b值为0和850 s/mm2。对病变的清晰度和 ADC 值进行了评估:RESOLVE的平均病灶清晰度评分(3.54 ± 0.65)明显高于SPEN(3.07 ± 0.91)或SS-EPI(2.48 ± 0.78)(P < 0.01)。SPEN 评分明显高于 SS-EPI 评分(P < 0.01)。模型测量显示,在所有浓度下,SPEN 的 ADC 值略低于 SS-EPI 和 RESOLVE。结果显示,在恶性病变中,SPEN(b = 0,850,1500 sec/mm2)的 ADC 值明显低于 SPEN(b = 0,850 sec/mm2)(P < 0.01),SPEN(b = 0,850 sec/mm2)、SS-EPI 和 RESOLVE 之间无明显差异。对于良性病变,SPEN(b = 0、850 秒/平方毫米)、SPEN(b = 0、850、1500 秒/平方毫米)、SS-EPI 和 RESOLVE 之间的 ADC 值无明显差异:结论:RESOLVE提供了最高的病灶清晰度,在b值为850-1000秒/平方毫米的序列中,乳腺病灶的ADC值没有明显差异。b值较高的SPEN(0、850、1500与0、850秒/平方毫米)在恶性病变中产生的ADC值明显较低,这凸显了在ADC量化中选择b值的重要性。
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Comparing Lesion Conspicuity and ADC Reliability in High-resolution Diffusion-weighted Imaging of the Breast.

Purpose: This study investigated the breast lesion conspicuity and apparent diffusion coefficient (ADC) reliability for three different diffusion-weighted imaging (DWI) protocols: spatiotemporal encoding (SPEN), single-shot echo-planar imaging (SS-EPI), and readout segmentation of long variable echo-trains (RESOLVE).

Methods: Sixty-five women suspected of having breast tumors were included in this study, with 44 lesions (36 malignant, 8 benign) analyzed further. Breast MRI was performed on a 3 Tesla (3T) system (MAGNETOM Prisma, Siemens) equipped with a dedicated 18-channel breast array coil for a phantom and patients. Three DWI protocols-SPEN, SS-EPI, and RESOLVE-were used. SS-EPI was acquired with an in-plane resolution of 2 × 2 mm2, a slice thickness of 3 mm, and b-values of 0 and 1000 s/mm2. SPEN had a higher in-plane resolution of 1 × 1 mm2, a slice thickness of 1.5 mm, and b-values of 0, 850, and 1500 s/mm2. RESOLVE was acquired with an in-plane resolution of 1 × 1 mm2, a slice thickness of 1.5 mm, and b-values of 0 and 850 s/mm2. Lesion conspicuity and ADC values were evaluated.

Results: The average lesion conspicuity scores were significantly higher for RESOLVE (3.54 ± 0.65) than for SPEN (3.07 ± 0.91) or SS-EPI (2.48 ± 0.78) (P < 0.01). The SPEN score was significantly higher than the SS-EPI score (P < 0.01). Phantom measurements indicated marginally lower ADC values for SPEN compared to SS-EPI and RESOLVE across all concentrations. The results revealed that SPEN (b = 0, 850, 1500 sec/mm2) yielded significantly lower ADC values compared to SPEN (b = 0, 850 sec/mm2) in malignant lesions (P < 0.01), with no significant difference observed between SPEN (b = 0, 850 sec/mm2), SS-EPI, and RESOLVE. For benign lesions, no significant difference in ADC values was found between SPEN (b = 0, 850 sec/mm2), SPEN (b = 0, 850, 1500 sec/mm2), SS-EPI, and RESOLVE.

Conclusion: RESOLVE provided the highest lesion conspicuity, and ADC values in breast lesions were not significantly different among sequences ranging b values 850-1000 sec/mm2. SPEN with higher b-values (0, 850, 1500 vs. 0, 850 sec/mm2) yielded significantly lower ADC values in malignant lesions, highlighting the importance of b-value selection in ADC quantification.

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