| Objective:Based on the 3.0TMR platform,the technical characteristics of GE breast dynamic enhanced three-dimensional volume interpolation fast phase gradient echo sequence(VIBRANT)were discussed,and the sequence parameters were optimized.At the same time,the correlation between the vascular characteristics around breast cancer and the prognostic factors of breast cancer was discussed.Methods:This study is divided into two aspects: the optimization of breast MRI dynamic enhancement technique and the study of the characteristics of blood vessels around breast cancer.In the first part,we prospectively study the image quality of parallel acquisition technology and zero filling technology.70 patients with breast diseases were selected and divided into two groups: group A(n = 35)and group B(n = 35).Group A was dynamic contrast-enhanced scan with parallel acquisition(ARC)technology,group B was dynamic contrast-enhanced scan without ARC technology.The scanning time,spatial resolution,signal-to-noise ratio and contrast of the two groups were calculated and statistically compared.The sensitivity,specificity and accuracy of dynamic enhanced MR were compared between group An and group B,and their correlation was analyzed.On the premise of keeping other parameters consistent,the zero filling experiment compared the two techniques of ZIP1024 and ZIP×2 after different combinations: group I: using both ZIP1024 and ZIP×2 technology;group II: using only ZIP*1024 technology;group III: not using ZIP technology.24 patients in group I and Ⅱ were scanned,and 26 patients in groupⅢ were scanned.The scanning time,spatial resolution,signal-to-noise ratio and contrast of the three groups were calculated and statistically compared.In the second part,the correlation between the peripheral vascular characteristics of breast cancer and prognostic factors of breast cancer was studied retrospectively.The imaging data of 102 patients with breast cancer confirmed by histopathology and dynamic contrast-enhanced MR were analyzed retrospectively.The maximum diameter of breast lesions was measured by ADW4.6 workstation,and the most obvious enhanced images and plain scan subtraction images were selected.The breast 3D-MIP images were obtained by intensity projection(maximumintensityprojection,MIP).The blood vessels around the tumor and the blood vessels on both sides of the breast were analyzed,and the length,diameter and number of blood vessels were recorded.The MR inspection equipment uses the 3.0T superconducting magnetic resonance scanner(Discovery MR750)produced by GE company in the United States.The imaging evaluation indexes of the tumor included shape,size,edge of the lesion,enhancement of the edge of the mass,dynamic curve,peri-tumor vascular sign and breast angiogenesis sign on the affected side.The correlation between these indexes and prognostic factors(ER,PR,HER-2)was analyzed.Results: In the first part,in the experiment of parallel acquisition technology,the average scanning time of group A was 7 minutes and 30 seconds,and that of group B was12 minutes and 38 seconds.The scanning time of group A was significantly shorter than that of group B,and there was significant difference between the two groups(P < 0.05).The signal-to-noise ratio of group An and group B was 28.37 and 29.45,respectively.The image contrast of group An and group B was 0.72 and 0.75,respectively.There was no significant difference in signal-to-noise ratio and contrast between the two groups(P >0.05).The sensitivity,specificity and accuracy of dynamic enhanced MRI diagnosis in group A were 100%,93.3% and 95.2%,respectively.In group B,the sensitivity,specificity and accuracy of dynamic enhanced MRI diagnosis were 100%,88.2% and 90%,respectively.There was no significant difference in sensitivity,specificity and accuracy of dynamic enhanced MRI diagnosis between the two groups(P > 0.05).In the experiment of zero filling technique,the spatial resolution and signal-to-noise ratio of group I images were the highest,followed by Voxelsize=0.25,SNR=61.12),II images,and the spatial resolution and signal-to-noise ratio of Voxelsize=0.49,SNR=35.20),III images were the worst(Voxelsize=1.58,SNR=28.91).There were significant differences in signal-to-noise ratio between group Ⅰ and group Ⅱ,group Ⅰ and group Ⅲ(P < 0.05),but there was no significant difference between group Ⅱ and group Ⅲ(P > 0.05).The contrast of group I,II and III was 0.76,0.75,0.73 respectively.There was no significant difference in image contrast among the three groups(P > 0.05).In the second part,the characteristics of peripheral blood vessels and prognostic factors of breast cancer were studied.in 102 cases of breast cancer,there were 90 cases of tumor shape mass type and 12 cases of non-mass type.The diameter of lesions ranged from 0.5cm to 5.6cm,of which 66 cases were ≥ 2cm and 36 cases were less than 2cm.The edge of the mass was spiny in 64 cases and the edge of the mass was other in 38 cases.In dynamic contrast-enhanced scan,marginal enhancement was found in 40 cases and other forms of enhancement in 62 cases.There were 4 cases of TIC ascending type(Ⅰ),19 cases of platform type(Ⅱ)and 79 cases of outflow type(Ⅲ).After the examination,the enhanced images were post-processed,the peripheral vascular sign was positive in 45 cases and negative in 57 cases,the ipsilateral vascularization sign was found in 61 cases,and there was no increase in 41 cases.According to the results of histopathology and immunohistochemistry,there were 80 cases of invasive carcinoma,20 cases of intraductal carcinoma,1 case of left breast mucinous carcinoma and 1 case of left breast spindle cell metaplastic carcinoma with mass necrosis.Among the 84 patients with breast cancer,there were 10 cases of grade Ⅰ,30 cases of grade Ⅱ and 44 cases of grade Ⅲ.The other 18 cases had no definite pathological grade.ER was positive in 74 cases and negative in 28 cases.PR was positive in 56 cases and negative in 46 cases.Low expression of Her-2 was found in 66 cases and overexpression in 36 cases.Statistical analysis showed that tumor morphology was correlated with peri-tumor vascular sign,but not with breast angiogenesis sign;tumor size was correlated with peritumoral vascular sign and mammary angiogenesis sign;tumor edge burr,tumor edge enhancement higher than internal histopathological grade and prognostic factors(ER,PR,Her-2)were not significantly correlated.The time signal curve was correlated with pathological grade,but not with ER,PR and HER-2.The peripheral vascular sign of breast cancer was significantly different from that of ER,PR and HER-2(P < 0 05),but not with histopathological grade(P > 0 05).There was significant difference between angiogenesis and ER and PR,but there was no significant difference with HER-2 and histopathological grade(P > 0.05).Conclusion: VIBRANT dynamic enhanced breast scan sequence based on parallel acquisition technology has good diagnostic sensitivity,specificity and accuracy,and does not affect its diagnostic efficiency on the premise of significantly shortening the scanning time.Technically,the simultaneous application of ZIP1024 and ZIP×2 technology can improve the image signal-to-noise ratio and improve the image quality.The increase of blood vessels and the positive peri-tumor vascular signs in the affected breast are correlated with the prognostic factors of breast cancer,which can provide reference value for clinical evaluation of the prognosis of patients with breast cancer. |
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