[Efficacy of dynamic susceptibility contrast MRI using echo-planar imaging in differential diagnosis of breast tumors].
It has been shown that T1-weighted dynamic MR imaging is a useful method in differentiating malignant breast tumors from benign lesions. Invasive breast carcinomas enhance more rapidly than benign lesions such as fibroadenomas, papillomas, and proliferative fibrocystic diseases. However, significant overlap in the dynamic profile of benign and malignant lesions may occur, resulting in relatively low specificity, which is an inherent limitation of this technique. The author attempted to improve diagnostic accuracy by utilizing dynamic susceptibility contrast MR imaging (DSC-MRI) with a single-shot echo-planar imaging sequence. Twenty-two patients underwent DSC-MRI using a 1.5-T unit (Magnetom Vision, Siemens). Images were obtained before, during and after the bolus injection of 20 mL of gadopentetate dimeglumine. The signal reduction rate within the first 30 seconds (delta RT2) was calculated by the following equation: delta RT2 = (postcontrast signal intensity-precontrast signal intensity)/precontrast signal intensity. A rapid, strong decrease in signal intensity was observed on the first pass of the contrast material in all cases of carcinoma, whereas no or only a minimal decrease in signal intensity was observed in all but one of the benign lesions. This method seems to be more accurate than T1-weighted dynamic MR imaging in the differentiation benign and malignant breast lesions. Since DSC-MRI can be performed quickly, subsequent conventional T1-weighted imaging can provide additional information about the morphologic features of lesions, to further support the diagnosis. In conclusion, DSC-MRI seems to be a promising method for the accurate preoperative assessment of breast lesions.
Yoshino
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Department of Radiology, Kyorin University School of Medicine.
D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000473:pathology; D003937:Diagnosis, Differential; D017352:Echo-Planar Imaging / Q000379:methods*; D005260:Female; D018226:Fibroadenoma / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008875:Middle Aged; D012680:Sensitivity and Specificity