Breast Masses: Study Of Contrast-enhanced Dynamic MR Imaging And Proton MR Spectroscopy

Purpose: To analysis the characteristics of breast diseases with before and after dynamiccontrast-enhanced MR images. To research the correlation for MR findings with histologicfeatures in breast tumours. To evaluate the value of proton magnetic resonance spcetroscopy (1H-MRS) for the application and diagnosis of breast masses.Materials and Methods:1. Tatall 115 cases had been trained by MR exammation between 1999.10～2001 .2 with 24～78years old, mean 49.93 ±13years old. CR mammography examed in 101cases of them andUltrasonography examed in 44cases of them.Single-voxel 1H-MR spcetroscopy were performed in 92 patients with single or doublebreasts and totall 248 nominal voxel sizes(1cm3) were examed, which include: 53 regions ofmaligment tumours, 40 regions of benign tumours, 155 regions of benign diseases andnormal breast tissues et al.2. MR examination: Using Magnetom Vision 1.5T MR instrument,turbo spin echosequence and fitting to small-flexible circle which was combined with breast trestle, MRimages had been obtained from T1WI and T2WI turbo-SE sequence include with sagittal.transverse and cross section, before. after and delay dynamic contraste-inhanced period.3. Pathologic examination: each tumour sample which was shown cleary on MRI wasundergone besides the rotine HE stain to Van Gieson and CD34 stain.4. Study methods of MRI:(1) To analysis of lesion morphyologic featurs on MRI.(2) To analysis the charateristics of enhancement kinetics, including:â‘ Enhancement rates(E%) should be quantified by ROI-based signal intensitymeasurements.To account for differences in baseline tissue T1 relaxation times,enhancement is calculated as signal intensity increase relative to baseline values: E%=(SI_pody-SI-(pre)) /SI_pre× 100%.@)The enhancement kinetics in the intermediate and late post-contrast period should be evaluated by means of time/signal intensity course(TIC). Three patterns of signal intensity time courses can be distinguished: Type I is a linear time course where enhancement persists until the late post-contrast period. Type II is a plateau curve where signal intensity reaches its maximum approximately 2-³ mm p.i., and then stays at this level(steady state). Type III is a wash-out time course where, as in Type II, peak enhancement is already reached in the early post-contrast period, 2-.-3 mm p.1., but here, this is followed by a loss of signal intensity.(I⁾Progression of internal lesion enhancement over the dynamic series should be analyzed.(3) Preoperation MR dignoses and compared with operation results.(4) The histopathological and immunohistochemical analysis of breast tumours:Ci)The size of the cancer nests was determined on the basis of the mean length of the major axis and was classified as small, medium, or large.(⁾The features of the stroma between cancer nests were determined on the basis of the mean width and morphology and were classified as delicate, narrow, or broad.^$jAll slices were subjeced to Van Gieson stain to depict collagenous materials and volume of fibrosis.Evaluation of fibrosis was performed in the peripheral, central, and surrounding areas of each lesion. Ratios of peripheral to central fibrosis were calculated for eath lesion.(I⁾The CD34 was used for microvessel quantification. The mean counts of the fields were recorded(microvessel density), and ratios of peripheral to central microvessel density were calculated for eath lesion.(5)Date processing: Every date was storaged by Microsoft Excel software and made to statistical analysis by SPASS Ver 10.0 and Powerpoint softwares.5.Study of Proton MR spectroscopy:(DTo analysis morphyologic features of deferent metabolic materials of lesions on MRS,and6divide them into two styles: Type I (non-tumour type, with "M" style of wave peaks between the position of Choline and Creatine), Type II (tumour type, "M" style wave peaks have disappeared).(^jThe metabolic materials i...