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Characterization of Lesions of the Breast with in Vivo ~1H MR Spectroscopy

Author: LuoXiaoZuo
Tutor: KongXiangQuan
School: Huazhong University of Science and Technology
Course: Medical Imaging and Nuclear Medicine
Keywords: Breast Dynamic enhancement Proton magnetic resonance spectroscopy
CLC: R655.8
Type: Master's thesis
Year: 2007
Downloads: 130
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Abstract


Objective: To evaluate proton magnetic resonance spectroscopy (1H MRS) technique in breast disease diagnosis and differential diagnosis value and the inspection method factor. Methods: 27 cases of clinically suspected or molybdenum target X-ray examination in patients with breast lesions suggestive of MR scan lines sequentially, dynamic enhanced scanning and spectral analysis, all sequences were collected axial images. Conventional positioning unenhanced scan, using inversion recovery (STIR) sequences T2WI and fast spin echo (TSE) sequence T2WI. Dynamic enhanced MRI fast low angle shot three-dimensional gradient echo (3D-FLASH) sequence pressurized grease T1WI, were scanned six times. After the scan is completed the 1st injection of contrast agent gadolinium acid spray for meglumine (Gd-DTPA) and saline injection immediately begin to complete five consecutive scans. In the conventional spectrum positioning spectroscopic examination, based on tumor size, shape, location and other specific circumstances choose single voxel spectroscopy (SVS) or chemical shift imaging (CSI). Single voxel dedicated breast examination using spin-echo single voxel spectroscopy (SVS-SE-BREAST) sequence, positioning try to include all the same lesions less surrounding tissue is not enhanced. Chemical shift imaging borrow prostate spectroscopy (CSI2D-SE-PROSTATE) sequence, adding pre-saturated fat suppression technique. Including three-dimensional reconstruction of image post-processing, Digital, drawing time - signal intensity curves and spectral analysis. Surgical pathology results as the gold standard, controlled before and after adding spectroscopic imaging diagnostic sensitivity, specificity and accuracy, and positive predictive value for biopsy. Paired chi-square test to compare and spectral analysis of dynamic contrast-enhanced MR diagnostic value. Results: 27 patients in two bilateral breast lesions, the total number of cases by 29 cases calculated. All cases were confirmed by pathology, tumor size 0.9cm ~ 6.0cm, average 2.8cm, including malignant lesions in 19 cases, including 16 cases of invasive breast cancer, mixed ductal lobular carcinoma, non-Hodgkin's lymphoma , sclerosing adenosis localized malignant one case; benign lesions in 10 cases, including three cases of fibroadenoma, cysts in 2 cases, 4 cases of breast adenosis, intraductal papilloma 1. 21 cases of successful magnetic resonance spectroscopy examination, seven cases due to manual shimming process mainly the local magnetic field homogeneity is always to give up spectrum examination, one case because the lesion was not found to strengthen and give up spectrum check on the success rate of 75%. Malignant lesions in 12 cases (total 12 cases) were clearly appears choline (tCho) peak, in one case of benign lesions (total 9 cases) appear tCho peak. Dynamic contrast-enhanced MR examination of traditional diagnostic sensitivity, specificity and accuracy were 84.2%, 70.0% and 79.3%; spectroscopic imaging diagnostic sensitivity, specificity and accuracy were 100%, 85.7% and 95.2%, and positive biopsy predictive value also increased from 84.2% to 93.3%. Paired chi-square test P> 0.05, that alone MR imaging spectroscopic examination and traditions have the same positive identification value, and can provide information on local lesion biochemical metabolism. CONCLUSION: Magnetic resonance spectroscopy technique benign and malignant lesions in the differential diagnosis with certainty the value of providing a lesion in vivo studies the molecular level changes in the new means of magnetic resonance traditional checking sequences necessary and effective supplement. Mammary gland in vivo spectroscopic examination success rate has yet to be improved.

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