Extra-mammary findings in breast MRI
Extra-mammary findings in breast MRI
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DOI：
10.1007/s00330-011-2183-6
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发表时间：
2011-11-01
影响因子：
5.9
通讯作者：
Bonomo, L.
中科院分区：
文献类型：
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作者：
Rinaldi, Pierluigi;Costantini, M.;Bonomo, L.
乳腺磁共振成像（MRI）中偶然的乳房外发现可能是良性的，但也可能代表转移或其他重要病变。我们对1535例乳腺MRI进行了回顾性分析，旨在分析这些意外发现的患病率和临床相关性。仅重新评估轴向序列。所有病例均获得了确认检查。285例患者有确认的偶然发现，位于肝脏（51.9%）、肺（11.2%）、骨（7%）、纵膈淋巴结（4.2%）或由胸腔/心包积液（15.4%）组成。20.4%的偶然发现被证实为恶性。如果转移灶位于骨（89%）、淋巴结（83%）和肺（59%）内，则MRI检测转移灶的阳性预测值较高，而如果转移灶位于肝脏（9%）或由胸腔/心包积液组成（6%），则阳性预测值较低。轴向增强序列在检测转移病灶方面显示出比未增强图像更高的上级灵敏度，尤其是在较小的情况下（千分之一货币符号10 mm）。转移性偶发乳腺外发现的患病率是不可忽略的。应特别注意位于肺、骨和纵隔淋巴结内的偶然发现。
Incidental extra-mammary findings in breast Magnetic Resonance Imaging (MRI) may be benign in nature, but may also represent a metastasis or another important lesion. We aimed to analyse the prevalence and clinical relevance of these unexpected findings.A retrospective review of 1535 breast MRIs was conducted. Only axial sequences were reassessed. Confirmation examinations were obtained in all cases.285 patients had a confirmed incidental finding, which were located in the liver (51.9%), lung (11.2%), bone (7%), mediastinal lymph nodes (4.2%) or consisted of pleural/pericardial effusion (15.4%). 20.4% of incidental findings were confirmed to be malignant. Positive predictive value for MRI to detect a metastatic lesion was high if located within the bone (89%), lymph nodes (83%) and lung (59%), while it was low if located within the liver (9%) or if it consisted of pleural/pericardial effusion (6%). The axial enhanced sequence showed superior sensitivity to unenhanced images in detecting metastatic lesions, especially if only smaller (a parts per thousand currency sign10 mm.) lesions were considered.The prevalence of metastatic incidental extra-mammary findings is not negligible. Particular attention should be to incidental findings located within the lung, bone and mediastinal lymph nodes.