Dynamic Contrast-enhanced MR Imaging With VIBRANT For Breast Lesions

Objectives:To evaluate the clinical value of multiphase contrast-enhanced MRI with VIBRANT for the diagnosis of breast lesions.Methods:1. Forty-five female patients were enrolled in this study who were confirmed as breast lesions verified by surgery and histopathology.45 patients had 20 malignant lesions in 18 cases and 28 benign lesions in 27 cases.2. The scanning protocol of plain include: Axial fat-saturation T1 weighted fast spoiled gradient echo, Sagittal fat-saturation T2 weighted fast spin-echo.The scanning protocol of contrast-enhanced MRI is sagittal multiphase contrast-enhanced MRI with VIBRANT by 8-channal phased-assay breast coil at 1. 5T (GE). Acquisition time of every phase about 57 seconds and 8 phases repeat acquisition with no intervals after Gd-DTPA (2.0ml/s, 0.1mmol/ kg) administration.3. The enhanced time- signal curve, the early enhanced rate, the peak enhanced time and the signal enhanced rate were used to analyze the features of benign or malignant tumor.4. To diagnose breast tumor by the parameters with MR VIBRANT5. We use T Test in 13.0 SPSS software to statistics all parameters.Results: All breasts, except for 1 case , had good fat saturation. There were significant differences between the malignant and benign lesions at morphology (P < 0. 01) and margin (P < 0. 01) characteristics, the diagnostic sensitivity and specificity of spinous margin for malignant lesions was 70% and 89.3%. The SER after Gd-DTPA administration was higher than that of the benign lesions (P < 0. 01) with sensitivity and specificity being 65%, 92.9%. The typeâ… (monophasic) of time-signal intensity curves for malignant lesions was 10% (2/ 20), typeâ…¡(biphasic) was 20% (4/ 20), and typeâ…¢(washout) was 65% (13/ 20). The typeâ… for benign lesions was 64.3 % (18/ 28), typeâ…¡was 17.9 % (5/ 28), typeâ…¢was 7.14 % (2/ 28), and typeâ…£was 10.71% (3/ 28). The diagnostic sensitivity and specificity was 81.3% and 91.3%. The combination of morphologic and kinetic characteristics had a sensitivity, specificity and accuracy of 85%, 89.3 %, 87.5 %.Conclusion:1. Multiphase contrast-enhanced MRI with VIBRANT can be acquired better information about morphologic and kinetic characteristics of breast lesions with better fat saturation.2. The time-signal intensity curve is useful in differentiating malignant lesions from benign ones.3. Tmax has better sensitivity while SER and spinous margin has better specificity for malignant lesions.4. The combination of morphologic and kinetic characteristics is useful to increase accuracy.