Incidental liver lesions seen on Breast MRI: When is additional imaging warranted?
Incidental liver lesions seen on Breast MRI: When is additional imaging warranted?
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DOI：
10.1016/j.ejrad.2017.08.018
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发表时间：
2017-10-01
影响因子：
3.3
通讯作者：
Mehta, Tejas
中科院分区：
文献类型：
--
作者：
Knox, Mark;Slanetz, Priscilla;Mehta, Tejas
目的：由于担心肝转移或其他重大肝脏病变，在乳腺MR上发现的偶发肝脏病变可能是一个诊断难题。本研究的目的是确定乳腺MR上肝脏病变的发生率和性质，并确定是否需要额外的imaging is necessary.Methods and Materials：对2010年1月1日至2011年12月31日在我院进行的所有乳腺MR检查的成像报告进行了审查，以确定肝脏异常的报告。病变特征，随后的诊断，随访时间和额外的成像结果（如果进行）都recorded.Results：1664乳腺MR，偶然肝病变被认为是在207项研究（12.4%）在169例患者。在169例患者中，154例（91.1%）的病变表现为T2高信号，在T2加权或定位序列上与邻近脂肪一样明亮。在临床或放射学随访时，这154处病变中0处具有临床意义。其余8.9%（15/169）的病灶在T2加权或定位成像上不如邻近脂肪明亮。在两例病例中，病变被证实为偶发性肝转移diseases.Conclusion：91.1%的偶发性肝病变是局限性的，T2高信号病变，其特点是在额外的审查T2加权成像上清晰明亮的邻近脂肪。在临床或放射学随访时，这些均不具有临床意义。我们主张，在T2加权成像上与邻近脂肪一样明亮的局限性T2高信号病变不太可能具有临床意义，不建议进行随访成像，将额外成像的比率从37.3%降至5.3%。
Purpose: Incidental hepatic lesions identified on breast MR can be a diagnostic dilemma due to concern for liver metastases or other significant hepatic lesions. The purpose of this study was to identify the incidence and nature of liver lesions seen on breast MR, and determine if additional imaging is necessary.Methods and materials: Imaging reports of all breast MR examinations performed at our institution from January 1, 2010 to December 31, 2011 were reviewed to identify reports with hepatic abnormalities. Lesion characteristics, subsequent diagnosis, duration of follow up and additional imaging results (if performed) were all recorded.Results: Of 1664 breast MRs, incidental hepatic lesions were seen in 207 studies (12.4%) in 169 patients. In 154 of 169 patients (91.1%) the lesions were characterized as T2 hyperintense and clearly as bright as adjacent fat on T2-weighted or localizer sequences. 0 of these 154 lesions were clinically significant at clinical or radiological follow-up. In the remaining 8.9% (15 of 169), lesions were characterized as not as bright as adjacent fat on T2 weighted or localizer imaging. In two cases, lesions were confirmed as incidental hepatic metastatic disease.Conclusion: 91.1% of incidental hepatic lesions were circumscribed, T2 hyperintense lesions and characterised as clearly as bright as adjacent fat on T2 weighted imaging at additional review. None of which were clinically significant at clinical or radiological follow-up. We advocate that circumscribed T2 hyperintense lesions which are clearly as bright as adjacent fat on T2 weighted imaging are of unlikely clinical significance and follow-up imaging should not be recommended, reducing the rate of additional imaging from 37.3% to 5.3%.