[Combination of low and high resolution T1-weighted sequences for improved evaluation of morphologic criteria in dynamic contrast enhanced MRI of the breast].
OBJECTIVE
Presentation of a new protocol for simultaneous acquisition of both low and high resolution T 1 -weighted images of breast lesions for dynamic contrast-enhanced MR mammography. Demonstration of possible diagnostic improvement with representative measurements in patients with suspected breast cancer by adding morphologic parameters from high resolution sequences to the analysis of the signal-time curve.


METHODS
Dynamic MR imaging was performed with a 1.5 T system (Magnetom SONATA, Siemens Medical Systems, Germany) and the manufacturer's double-breast coil. Coronal T 1 -weighted 3D FLASH sequences (spatial resolution 1.25 x 1.25 mm 2; slice thickness 1.7 mm) were acquired once before and five times after administration of contrast medium (Gd-DTPA, 0.15 mmol/kg) injection. In addition, a high resolution T 1 -weighted 3D-FLASH sequence (spatial resolution, 0.63 x 0.63 mm 2) was obtained before administration of contrast medium and after the third post-contrast low-resolution sequence. Except for the acquisition matrix, all imaging parameters were identical for both 3D pulse sequences. To assure comparison of the measured signal intensities for both T 1 -weighted sequences, calibrating phantom measurements were performed using a dilution series of Gd-DTPA.


RESULTS
Phantom measurements demonstrated similar signal intensities and enhancement pattern for both sequences. A combined protocol consisting of both pulse sequences can be employed and does not interfere with the signal-time curve analysis. By measuring one high resolution sequence 3:18 minutes after administration of contrast medium, morphologic features can be evaluated without interference from barely enhancing surrounding tissue. The overall study time is not increased. The improved spatial resolution slightly increases the severity of motion artifacts.


CONCLUSIONS
The new protocol is a clever way to improve the measurement of morphologic features without relevant loss of dynamic information. It is superior to converting the entire investigation to high resolution sequences and does not add any costs by not extending or duplicating the investigation. How much the new protocol can improve the specificity or sensitivity of MR-mammography is currently investigated on a larger patient group.
Vomweg
T W
TW
Klinik und Poliklinik für Radiologie, Klinikum der Universität Mainz, Germany. vomweg@radiologie.klinik.uni-mainz.de
Teifke
A
A
Schreiber
W G
WG
Schmidt
M
M
Thelen
M
M
D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D018276:Carcinoma, Medullary / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D019047:Phantoms, Imaging
D003287:Contrast Media; D019786:Gadolinium DTPA