Figure 2d. (a) Spectra acquired at 1H MR spectroscopy with 135-msec TE in patient 17 are positive for choline in the breast and negative for choline in the axillary lymph node. The nominal voxel volume was 3.4 cm3 for both the breast and the axillary lymph node. (b) Transverse fat-suppressed subtraction MR image (450/12) obtained in the same patient shows two carcinomas in the left breast. The larger lesion (arrow) is slightly lobulated, has an indistinct margin, and shows the characteristic peripheral enhancement with a central nonenhancing nidus. This lesion was selected for MR spectroscopic analysis. (c) Sagittal contrast-enhanced MR image (450/12) obtained in the same patient shows a 1-cm lymph node (arrow). (d) Close-up sagittal contrast-enhanced MR image (450/12) of the node shown in c shows preservation of the nodal architecture, including the hyperintense central hilum and the hypointense peripheral cortex.