Surgery – Diagnostic testing – Detecting nuclear – electromagnetic – or ultrasonic radiation
Reexamination Certificate
1999-03-16
2002-06-25
Smith, Ruth S. (Department: 3737)
Surgery
Diagnostic testing
Detecting nuclear, electromagnetic, or ultrasonic radiation
C324S309000
Reexamination Certificate
active
06411837
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention is directed to a method for chronologically high-resolution magnetic resonance tomography, particularly of the female breast.
2. Description of the Prior Art
Primary tumor diagnosis in the female breast with the aid of nuclear spin tomography, i.e., magnetic resonance tomography (MRT), occurs by means of a dynamic investigation in which the enhancement behavior of a paramagnetic contrast agent is evaluated. The contrast agent is injected into a vein in the arm in a small dose—on the order of 20 mL. As a secondary injection, a physiological saline solution is used, so that the contrast agent reaches the blood circulation completely. The respective shortening of the relaxation times by the contrast agent is exploited for purposes of imaging. Given lower contrast agent concentration, primarily the T
1
time is shortened; given higher concentration, the T
2
*—time is shortened. Given typical sequences, such as the spin-echo sequence or the gradient echo sequence, the shortening of T
1
leads to a signal rise, while the T
2
* effect produces a signal reduction.
Although T
1
-sensitive sequences are generally used in dynamic contrast agent examinations, T
2
*-sensitive sequences such as echo planar imaging (EPI) can be utilized.
The contrast agent examinations are preferably conducted bilaterally, i.e. both breasts simultaneously. This saves examination time, since, given a unilateral examination, due to the use of the contrast agent, the second breast can not be examined immediately after the first. In addition, the patient is not stressed by a second injection. The MR imaging can then ensue either in the transversal or the coronary slice orientation. The coronary orientation has the advantage that a rectangular field of view can be selected, thereby halving the measuring time compared to the transversal orientation without a reduction of the spatial resolution.
Recent work suggests that a high time resolution in the imaging of the examined region in the area of 2 s, can improve the specificity of the contrast agent method. This method uses the flow of the contrast agent through the aorta as a time reference. To achieve such a time resolution, the transversal orientation has been selected, in order to image the aorta simultaneously. This kind of method is described in the article: “MR Characterization of Suspicious Breast Lesions with a Gadolinium-enhanced TurboFLASH Subtraction Technique” (Boetes;
Radiology
, 1994; 193: 777-781).
Another method in magnetic resonance tomography of the breast which uses a time resolution on the same order of magnitude is described in the article “Breast Neoplasms: T
2
* Susceptibility-Contrast, First-Pass Perfusion MR Imaging” (Kuhl,
Radiology
, 1997;202, No.1:87-95). There, the T
2
* effect of the contrast agent is used to determine the perfusion of a lesion. Basically, the contrast agent shortens both the T
1
and the T
2
* times. In the T
1
-weighted image, a signal rise occurs, while in the T
2
*-weighted image, the shortening of the T
2
* time creates a signal drop. This effect dominates given high contrast agent concentrations. It is also stated that there is not a linear relation between contrast agent enhancement and perfusion in the T
1
-weighted image. Nevertheless, T
1
-weighted images are usually faster to create and do not require such a high equipment outlay as the creation of T
2
*-weighted images. One exception is EPI, which permits rapid imaging, but which is susceptible to artefacts and places high demands on equipment technology.
U.S. Pat. No. 4,871,966 describes how image data are obtained from different slices within a scan, these slices having different angles relative to one another.
German PS 37 17 871 teaches a method and an apparatus for the reproducible optical display of a surgical intervention. To this end, tomograms of the corresponding body region are prepared and stored, at least three measuring points being marked, fixed, or defined on the body part.
German PS 43 37 503 describes a method for spatially resolved blood flow measurement by means of NMR. To shorten the measuring time, while the maximum amplitude of the phase coding gradient remains constant, the number of phase coding steps is reduced relative to a number of steps required for the generation of a square field of view to such an extent that essentially only the examined blood vessel is covered in the phase coding direction.
SUMMARY OF THE INVENTION
An object of the present invention is to provide a method for chronologically high-resolution magnetic resonance tomography of the female breast.
The inventive method for achieving this object includes the following steps. A number of chronologically sequential images of the breast in a first slice orientation are produced. At least one tomogram is produced with a time correlation to the images and in perpendicular orientation relative to the first slice orientation. This tomogram, which is oriented perpendicularly to the first slice orientation, is positioned such that the contrast agent in the aorta can be detected. The appearance of the contrast agent bolus in the tomogram can then be used as a time reference for the successive images of the breast in the first slice orientation. The detected contrast agent bolus then also can be used to check whether the contrast agent has reached the bloodstream entirely.
In one embodiment, the tomogram is positioned such that it does not intersect the images in the first slice orientation. The magnetic resonance signals for the projections and the tomogram which is perpendicular thereto thus can be acquired chronologically interleaved, i.e., magnetic resonance signals from one volume element can be measured while the state of equilibrium of the nuclear spin has not yet been reached again in the other volume element. The overall time for the production of a number of images thus can be shortened.
In another embodiment, the images and the perpendicularly oriented tomogram are produced in alternation. Thus, all the magnetic resonance tomograms are available to an examiner in order to be able to analyze the enhancement behavior of the contrast agent.
REFERENCES:
patent: 4871966 (1989-10-01), Smith et al.
patent: 4994743 (1991-02-01), Glover et al.
patent: 5251629 (1993-10-01), Koizumi et al.
patent: 5278506 (1994-01-01), Schmitt
patent: 5400377 (1995-03-01), Hu et al.
patent: 5415163 (1995-05-01), Harms et al.
patent: 5436562 (1995-07-01), Dumoulin
patent: 5590655 (1997-01-01), Hussman
patent: 5613492 (1997-03-01), Feinberg
patent: 5678549 (1997-10-01), Heywang-Koebrunner
patent: 5687725 (1997-11-01), Wendt
patent: 5913863 (1999-06-01), Fischer et al.
patent: PS 43 37 503 (1995-02-01), None
patent: PS 37 17 871 (1995-05-01), None
“MR Characterization of Suspicious Breast Lesions with a Gadolinium-enhanced TurboFLASH Subtraction Technique,” Boetes et al., Radiology, vol. 193 (1994), pp. 777-781.
“Breast Neoplasms: T2* Susceptibility-Contrast, First-Pass Perfusion MR Imaging,” Kuhl et al., Radiology, vol. 202 (1997), pp. 87-95.
Schiff & Hardin & Waite
Siemens Aktiengesellschaft
Smith Ruth S.
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