3特斯拉扩散加权乳腺MRI：水激发和光谱脂肪抑制结合提升病灶可见性和图像质量

Diffusion-weighted Breast MRI at 3 Tesla: Improved Lesion Visibility and Image Quality with a Combination of Water-excitation and Spectral Fat Saturation

ACADEMIC RADIOLOGY

影响因子:3.9

分区:医学2区 / 核医学2区

发表日期:2023 Sep

作者: Stephanie Tina Sauer, Sara Aniki Christner, Tanja Schlaiß, Corona Metz, Andrea Schmid, Andreas Steven Kunz, Thomas Pabst, Elisabeth Weiland, Thomas Benkert, Thorsten Alexander Bley, Jan-Peter Grunz

DOI: 10.1016/j.acra.2023.01.014

摘要

在乳腺扩散加权成像（DWI）中，脂肪抑制对于消除占主导地位的脂质信号至关重要。本研究评估了一种结合水激发-光谱脂肪抑制（WEXfs）与标准光谱衰减反转恢复（SPAIR）技术的高分辨率3特斯拉乳腺MRI方法。对83名患者（平均年龄50.1 ± 12.6岁）进行了多参数乳腺MRI，采用两种不同的DWI回波平面成像序列，使用WEXfs或SPAIR进行脂肪信号抑制。三名放射科医评估了在b值为800和1600 s/mm²条件下的88个病灶（其中28例恶性，60例良性）图像的整体质量及病灶轮廓清晰度，以及表观弥散系数（ADC）图像。每种脂肪抑制方法和b值下，测定了最大病灶直径，并在标准区域内测量了DWI信号强度和ADC值。结果显示，无论b值如何，WEXfs-DWI在良性和恶性病变中的图像质量（全部p < 0.001）和病灶轮廓清晰度（全部p ≤ 0.003）均优于SPAIR-DWI。无论病变类型，WEXfs-DWI在1600 s/mm²条件下均表现出更优的信噪比、对比噪声比及信号强度比（全部p ≤ 0.05）。WEXfs脂肪抑制的病灶尺寸与对比增强T1减影图像的差异较小（全部p ≤ 0.007）。恶性病变的平均ADC值在WEXfs-DWI中较低（p < 0.001），而两种技术在良性病变中的ADC值无显著差异（p = 0.947）。综上，WEXfs-DWI在主观和客观图像质量方面优于标准SPAIR-DWI，有助于更准确地评估良恶性病变的大小。

Abstract

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.