Incidentally detected lesions on contrast-enhanced MR imaging in candidates for breast-conserving therapy: Correlation between MR findings and histological diagnosis
Incidentally detected lesions on contrast-enhanced MR imaging in candidates for breast-conserving therapy: Correlation between MR findings and histological diagnosis
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DOI：
10.1002/jmri.20532
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发表时间：
2006-04-01
影响因子：
4.4
通讯作者：
Hachitanda, Y
中科院分区：
文献类型：
--
作者：
Yabuuchi, H;Kuroiwa, T;Hachitanda, Y
目的：为探讨乳腺癌MR表现与乳腺癌保乳手术中偶然发现的乳腺癌组织学诊断的相关性，材料与方法：回顾性分析299例乳腺癌患者的MR表现。299例患者中有59例（20%）发现了偶然发现的病变，59例患者中有48例（81%）获得了组织学诊断。良性病变25例，恶性病变23例。数量，大小，位置。分析其形态学特征及动力学曲线评价。结果：直径大于10 mm的病灶多为恶性（11/16; 69%），小于等于5 mm的病灶多为良性（12/17：71%; P < 0.05）。与主病灶位于同一象限的病灶多为恶性（20/27.5; 73%），而位于不同象限的病灶多为良性（1.7.5/20.5; 85%; P < 0.001）。早期强化峰值的病灶倾向于恶性（20/25; 80%），持续强化的病灶倾向于良性（20/23：87%：P < 0.001）。结论：偶然发现的病灶位于主病灶的不同象限，直径小于10 mm，MRI上显示持续强化，提示良性病变。因此，此类病变的患者应避免不必要的外科手术，除非细胞学或活检证实病变为恶性。
Purpose: To investigate the correlation between MR findings and the histological diagnosis of incidentally detected lesions in candidates for breast-conserving therapy.Materials and Methods: MR images of 299 patients with breast cancer were reviewed. Incidentally detected lesions were noted in 59 of 299 (20%) patients, and a histological diagnosis was obtained in 48 of 59 (81%) patients. There were 25 benign and 23 malignant lesions. The number, size, location. morphologic character, and kinetic curve assessment of the MR findings were analyzed. Statistical analyses were performed to determine whether any differences could be observed between benign and malignant lesions.Results: Lesions of over 10 mm tended to be malignant (11/16; 69%), whereas those equal or less than 5 mm tended to be benign (12/17: 71%; P < 0.05). Lesions in the same quadrant as the main lesion tended to be malignant (20/27.5; 73%), whereas those in a different quadrant tended to be benign (1.7.5/20.5; 85%; P < 0.001). Lesions with early peak of enhancement tended to be malignant (20/25; 80%), whereas those with persistent enhancement tended to be benign (20/23: 87%: P < 0.001).Conclusion: Incidentally detected lesions that are found in a different quadrant from the main lesion, are smaller than 10 mm in diameter, and show persistent enhancement on MR imaging suggest benign lesions. Therefore, patients with such lesions should avoid unnecessary surgical procedures unless lesions are proved to be malignant by cytology or biopsy.