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Objective: (1) investigate the proton MR spectroscopy (1H-MRS) combined dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in breast cancer clinical applications. (2) investigate the 1H-MRS low sensitivity factor. Materials and Methods: 38 cases of breast cancer patients (all patients were untreated primary breast lesions, has significantly enhanced and confirmed by pathology) were underwent conventional MRI scan, DCE-MRI and 1H-MRS examination. Using GE 1.5T superconductive MR scanner and dedicated breast surface coil. Patients were prone position, bilateral breast drooping naturally, to keep the body scan does not move. Conventional MRI scan using the following sequence: axial T2WI fat suppression (STIR), axial T1WI (FSE), sagittal T2WI saturated fat suppression (FSE). LAVA using dynamic contrast-enhanced axial scanning sequence of lines breasts. Median cubital vein injection of contrast agent (Gd-DTPA) 20ml, injection rate of 2.5ml / s, before the injection of contrast agent as scanning a mask, while the contrast agent injection start scanning, continuous scanning without interval 7 to 9, a single phase acquisition time of 55 seconds. All cases were in enhanced scan using single voxel space spectrum spin echo point resolved spectroscopy (SS-PRESS) OK 1H-MRS examination showed lesions most clearly chosen level position to do, like, three-dimensional voxel zone volume is not less than 2.0cm3 . In AW4.1 workstation using Add / Sub software enhanced with the mask for each image subtraction of subtraction image after morphological analysis and hemodynamic analysis. With 3D-MIP and VR observed around the lesion without distortion, thickening vascular imaging. Take the most obvious area of ??lesion enhancement region of interest (ROI), ROI size of 5 ~ 10mm2, functional software with Functool areas of interest for signal strength measurements, drawing time - signal intensity curve. Functool single voxel spectroscopy using software analysis package automatically spectral data analysis, mainly to observe whether the choline peak appears. Results: 20 cases of pathologically confirmed breast cancer, benign tumors in 18 patients. 20 cases of breast dynamic contrast-enhanced scans obvious ring enhancement, including two cases of time - signal intensity curve showed a slow increase in type (I type), 6 cases rising platform type (II type), 12 cases were Kuaijinkuaichu type (III type); 1H-MRS examination in 11 cases of choline peak, invasive ductal carcinoma in 8 cases, including six cases were Ⅲ type curve of the lesion and 2 cases were type Ⅱ curve lesions, invasive lobular carcinoma in 3 cases, including 2 cases were type Ⅰ curves lesions and one case of the lesions were type Ⅱ curve. 18 cases of benign nodular dynamic enhanced CT was significantly enhanced, including 12 cases of time - signal intensity curve type I, six cases were type II; 1H-MRS choline peak examination 3 cases, including one case of fibroadenoma with breasts chronic mastitis, two cases of giant fibroadenoma puberty, the three cases of lesion time - signal intensity curves were type Ⅱ. Time - signal intensity curve sensitivity of diagnosis of breast cancer was 90.0%, specificity 66.7%, accuracy 78.9%; choline peak sensitivity of diagnosis of breast cancer was 55.0%, specificity 83.3%, accuracy 68.4%; two combined with a sensitivity of 100%, specificity 66.7%, accuracy 84.2%. Conclusion: 1H-MRS choline peak detection affected by many factors. Since the lesion itself and the technology and other factors, choline peak separate diagnosis of breast cancer is less sensitive, 1H-MRS and DCE-MRI combines a comprehensive analysis of the lesion, can improve the accuracy of MRI diagnosis of breast cancer.
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