在乳腺MRI中，扩散加权成像（DWI）中的脂肪抑制对于消除主要的脂肪信号至关重要。本研究评估了高分辨率3特斯拉乳腺MRI中的结合了水-激发-光谱-脂肪饱和度方法（WEXfs）和标准光谱衰减反转恢复（SPAIR）的比较。在83名患者（50.1 ± 12.6岁）中，使用WEXfs或SPAIR进行脂肪信号抑制，进行了带有2个回声平面DWI序列的多参数乳腺MRI。三名放射科医师评估了具有b值800和1600s/mm2的图像上88个病灶（28个恶性，60个良性）的DWI总体质量和分辨力，以及明显的扩散系数（ADC）地图。针对每个脂肪抑制方法和b值，测量了最长的病变直径，并在感兴趣的标准化区域中测量了DWI和ADC值的信号强度。无论b值如何，与SPAIR-DWI相比，WEXfs-DWI在良性和恶性病变的图像质量（所有p <0.001）和分辨率（所有p ≤ 0.003）上都被认为更优。无论病变种类如何，WEXfs-DWI在1600 s/mm2下提供了更好的信噪比、对比度和信号强度比率（所有p ≤ 0.05）。与SPAIR脂肪抑制相比，WEXfs的病变大小在对比增强T1减影图像和DWI之间的差异较小（所有p ≤ 0.007）。恶性病变的平均ADC值在WEXfs-DWI下较低（p <0.001），而在良性病变的两种技术之间没有确定显著的ADC差异（p = 0.947）。WEXfs-DWI提供了比标准SPAIR-DWI更好的主观和客观图像质量，从而更准确地估计了良性和恶性病变的大小。版权所有©2023年大学放射学协会。由Elsevier Inc.出版，保留所有权利。

In breast MRI with diffusion-weighted imaging (DWI), fat suppression is essential for eliminating the dominant lipid signal. This investigation evaluates a combined water-excitation-spectral-fatsat method (WEXfs) versus standard spectral attenuated inversion recovery (SPAIR) in high-resolution 3-Tesla breast MRI.Multiparametric breast MRI with 2 echo-planar DWI sequences was performed in 83 patients (50.1 ± 12.6 years) employing either WEXfs or SPAIR for fat signal suppression. Three radiologists assessed overall DWI quality and delineability of 88 focal lesions (28 malignant, 60 benign) on images with b values of 800 and 1600 s/mm2, as well as apparent diffusion coefficient (ADC) maps. For each fat suppression method and b value, the longest lesion diameter was determined in addition to measuring the signal intensity in DWI and ADC value in standardized regions of interest.Regardless of b values, image quality (all p < 0.001) and lesion delineability (all p ≤ 0.003) with WEXfs-DWI were deemed superior compared to SPAIR-DWI in benign and malignant lesions. Irrespective of lesion characterization, WEXfs-DWI provided superior signal-to-noise, contrast-to-noise and signal-intensity ratios with 1600 s/mm2 (all p ≤ 0.05). The lesion size difference between contrast-enhanced T1 subtraction images and DWI was smaller for WEXfs compared to SPAIR fat suppression (all p ≤ 0.007). The mean ADC value in malignant lesions was lower for WEXfs-DWI (p < 0.001), while no significant ADC difference was ascertained between both techniques in benign lesions (p = 0.947).WEXfs-DWI provides better subjective and objective image quality than standard SPAIR-DWI, resulting in a more accurate estimation of benign and malignant lesion size.Copyright © 2023 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.