Differentiation of benign from malignant breast disease associated with screening detected microcalcifications using dynamic contrast enhanced magnetic resonance imaging
Differentiation of benign from malignant breast disease associated with screening detected microcalcifications using dynamic contrast enhanced magnetic resonance imaging
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DOI：
10.1016/j.breast.2005.05.002
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发表时间：
2006-02-01
期刊：
影响因子：
3.9
通讯作者：
Turnbull, LW
中科院分区：
文献类型：
--
作者：
Kneeshaw, PJ;Lowry, M;Turnbull, LW
动态对比增强磁共振成像（DCE-MRI）是诊断症状性乳腺疾病的有效方法。然而，它在评估与乳房x线摄影检测到的微钙化相关的临床隐匿性疾病中的作用尚不清楚。有微钙化的妇女在乳房x光筛查后进行DCE-MRI检查。使用经验和2室药代动力学建模技术对数据进行主观和客观评价，以评估信号强度参数。88例患者年龄50-75岁（中位58岁）。对比良恶性病变，在最强增强9像素平方+/- 1标准差范围内，1 min增强指数任意单位平均值分别为0.61 +/- 0.40和0.22 +/- 0.26,p = < 0.001，敏感性、特异性、PPV、NPV和准确性分别为80.0%、82.4%、57.1%、93.3%和81.8%。放射科医师获得的相应值分别为75.0%、89.7%、68.2%、92.4%和86.4%。DCE-MRI能够区分与微钙化相关的临床隐匿性病变的恶性与良性，因此对于在对乳房微钙化进行初步三重评估后发现模棱两可的女性，可以作为开放式手术活检的替代选择。(c) 2005 Elsevier Ltd版权所有。
Dynamic Contrast Enhanced Magnetic Resonance Imaging (DCE-MRI) is an effective diagnostic modality for symptomatic breast disease. However, its rote in evaluating clinically occult disease associated with mammographically detected microcalcification remains unclear.Women recalled following screening mammography with microcalcification had DCE-MRI examination of the breast. The data were evaluated subjectively and objectively using both empirical and 2-compartment pharmacokinetic modelling techniques to evaluate signal intensity parameters.Eighty-eight patients aged 50-75 years (median 58) were recruited. Comparing malignant and benign lesions, the mean values in arbitrary units for the enhancement index at 1 min in the most enhancing 9-pixel square +/- 1 standard deviation were 0.61 +/- 0.40 vs. 0.22 +/- 0.26 p = < 0.001 with sensitivity, specificity, PPV, NPV and accuracy of 80.0%, 82.4%, 57.1%, 93.3% and 81.8%, respectively. The corresponding values attained by the radiologist were 75.0%, 89.7%, 68.2%, 92.4% and 86.4%.DCE-MRI is able to differentiate malignant from benign clinically occult lesions associated with microcalcification and may therefore offer an alternative to open surgical biopsy for women with equivocal findings following initial triple assessment for microcalcification in the breast. (c) 2005 Elsevier Ltd. All rights reserved.