A review of current evidence-based clinical applications for breast magnetic resonance imaging.
A review of current evidence-based clinical applications for breast magnetic resonance imaging.
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DOI：
10.1097/rmr.0b013e31818a40a5
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发表时间：
2008-06-01
期刊：
影响因子：
--
通讯作者：
Lehman, Constance
中科院分区：
文献类型：
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作者：
DeMartini, Wendy;Lehman, Constance
磁共振成像(MRI)是一种重要的乳房成像新工具。核磁共振现在已被证明是检测乳腺癌最敏感的成像方法，可以描绘出乳房X光检查、超声和临床乳房检查中隐匿的癌症。这是由于良恶性病变的特征重叠而导致的不完美的特异性，以及与其他乳房成像测试相比更高的检查成本和更有限的可获得性。这篇文章描述了目前基于证据的临床使用乳腺MRI的适应症。具体地说，MRI已被证明在癌症评估方面具有优势，可用于筛查高危患者、评估新诊断为乳腺癌的患者、监测接受新辅助化疗的患者以及评估转移性腋下腺癌和原发灶不明的患者。该工具也已被证明是有用的评估硅胶乳房植入物的完整性。对于可疑的乳房X光检查或临床发现，使用乳腺MRI作为解决问题的技术是有争议的。对于这些临床应用中的每一个，都将审查有关乳腺MRI诊断准确性的证据。了解目前的证据将有助于最适当地利用这一重要的医疗资源。
Magnetic resonance imaging (MRI) is an important new tool for imaging of the breast. MRI has now been demonstrated to be the most sensitive imaging method for detecting breast carcinoma, allowing depiction of cancers that are occult on mammography, ultrasound, and clinical breast examination. This is tempered by imperfect specificity due to overlap in the features of benign and malignant lesions, and by higher examination cost and more limited availability compared to other breast imaging tests. This article describes the current evidence-based clinical indications for use of breast MRI. Specifically, MRI has been shown to be advantageous for cancer assessment for screening patients at high risk, evaluating patients with a new breast cancer diagnosis, monitoring patients undergoing neoadjuvant chemotherapy, and evaluating patients with metastatic axillary adenocarcinoma and unknown primary site. This tool has also been shown to be useful for the evaluation of silicone breast implant integrity. Employment of breast MRI as a problem solving technique for equivocal mammographic or clinical findings is controversial. For each of these clinical applications, the evidence regarding the diagnostic accuracy of breast MRI will be reviewed. An understanding of the current evidence will facilitate the most appropriate utilization of this important medical resource.