乳腺X线摄影及动态增强MRI对BI-RADS 4-5微钙化病变的诊断价值

doi:10.7517/issn.1674-0475.200302

影像科学与光化学 ›› 2020, Vol. 38 ›› Issue (5): 815-821.DOI: 10.7517/issn.1674-0475.200302

乳腺X线摄影及动态增强MRI对BI-RADS 4-5微钙化病变的诊断价值

徐金亮¹, 滕心瑞¹, 刘宝良¹, 马捷²

1. 深圳市龙岗区第三人民医院, 广东深圳 518115;
2. 深圳市人民医院, 广东深圳 518020

收稿日期:2020-03-06 出版日期:2020-09-15 发布日期:2020-09-15
基金资助:
深圳市科技研发基金（JCYJ20180305164740612）

A Comparative Study of the Diagnostic Value of Dynamic Contrast-enhanced Magnetic Resonance Imaging and Mammography on Patients with BI-RADS 4-5 Microcalcifications

XU Jinliang¹, TENG Xinrui¹, LIU Baoliang¹, MA Jie²

1. The Third People's Hospital of Longgang District, Shengzhen 518115, Guangdong, P. R. China;
2. Shenzhen People's Hospital, Shengzhen 518020, Guangdong, P. R. China

Received:2020-03-06 Online:2020-09-15 Published:2020-09-15

摘要/Abstract

摘要： 探讨乳腺X线摄影（MG）及动态增强MRI （DCE-MRI）两种检查方法，对乳腺影像报告及数据系统（BI-RADS）评估建议组织学诊断的仅表现为微钙化病变的诊断价值。回顾性分析经BI-RADS评估后建议组织学诊断的298个病变，仅表现为微钙化和MG评估BI-RADS 4类和5类，其中52例在MG检查后一周内行DCE-MRI检查。DCE-MRI将BI-RADS 1～3类归为阴性，BI-RADS 4～5类归为阳性，MG将BI-RADS 4A归为阴性，BI-RADS 4B、4C、5归为阳性，将两种影像学检查的BI-RADS评估与病理组织学进行对照。DCE-MRI检查的灵敏度、特异度、准确性，阳性预测值、阴性预测值及阳性似然比均高于MG。DCE-MRI与MG联合诊断，其灵敏度、阴性预测值均高于单独DCE-MRI及MG检查。研究表明，MRI诊断效能较乳腺X线摄影高，两种影像学方法联合应用可以提高可疑病变的诊断准确性，避免不必要的活检。

关键词: 动态增强磁共振, 乳腺X线摄影, 微钙化, 组织学诊断

Abstract: To explore the diagnostic value of mammography (MG) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in lesions only appeared as microcalcifications requiring histological diagnosis suggested by BI-RADS evaluation. A retrospective analysis was made on 298 lesions requiring histological diagnosis suggested by BI-RADS evaluation, only appeared as microcalcifications, and classified as BI-RADS categories 4, 5 after MG evaluation, of which 52 patients underwent DCE-MRI examination within one week after MG examination. This study considered BI-RADS categories 1-3 as negative and BI-RADS categories 4-5 as positive through DCE-MRI, considered BI-RADS category 4A 815 as negative and BI-RADS 4B, 4C and 5 as positive through MG. The BI-RADS evaluation of the two imaging examinations was compared with the histopathology. The sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV) and positive likelihood ratio of DCE-MRI were all higher than MG. The sensitivity and negative predictive value of DCE-MRI combined with MG were higher than those of DCE-MRI and MG alone. The results showed that MRI diagnosis was more effective than mammography. The combined application of the two imaging methods can improve the diagnosis accuracy of suspicious lesions and avoid unnecessary biopsy.

Key words: dynamic contrast-enhanced magnetic resonance imaging, mammography, microcalcifications, histological diagnosis

徐金亮, 滕心瑞, 刘宝良, 马捷. 乳腺X线摄影及动态增强MRI对BI-RADS 4-5微钙化病变的诊断价值[J]. 影像科学与光化学, 2020, 38(5): 815-821.

XU Jinliang, TENG Xinrui, LIU Baoliang, MA Jie. A Comparative Study of the Diagnostic Value of Dynamic Contrast-enhanced Magnetic Resonance Imaging and Mammography on Patients with BI-RADS 4-5 Microcalcifications[J]. Imaging Science and Photochemistry, 2020, 38(5): 815-821.

参考文献

[1] Bluekens A M, Holland R, Karssemeijer N, et al. Comparison of digital screening mammography and screen-film mammography in the early detection of clinically relevant cancers:a multicenter study[J]. Radiology, 2012, 265(3):707-714.
[2] Karamouzis M V, Likaki-Karatza E, Ravazoula P, et al. Non-palpable breast carcinomas:Correlation of mammographically detected malignant-appearing microcalcifications and molecular prognostic factors[J]. International Journal of Cancer, 2002, 102(1):86-90.
[3] Stomper P C, Connolly J L, Meyer J E, et al. Clinically occult ductal carcinoma in situ detected with mammography:analysis of 100 cases with radiologic-pathologic correlation[J]. Radiology, 1989, 172(1):235-241.
[4] Menell J H, Morris E A, Dershaw D D, et al. Determination of the presence and extent of pure ductal carcinoma in situ by mammography and magnetic resonance imaging[J]. Clinical Imaging, 2006, 30(3):225-225.
[5] Rinaldi P, Buccheri C, Giuliani M, et al. Sensitivity of breast MRI for ductal carcinoma in situ appearing as microcalcifications only on mammography[J]. Clinical Imaging, 2016, 40(6):1207-1212.
[6] Cilotti A, Iacconi C, Marini C, et al. Contrast-enhanced MR imaging in patients with BI-RADS 3-5 microcalcifications[J]. La Radiologia Medica, 2007, 112(2):272-286.
[7] Westerhof J P, Fischer U, Moritz J D, et al. MR imaging of mammographically detected clustered microcalcifications:is there any value?[J]. Radiology, 1998, 207(3):675-681.
[8] Bazzocchi M, Zuiani C, Panizza P, et al. Contrast-enhanced breast MRI in patients with suspicious microcalcifications on mammography:results of a multicenter trial[J]. American Journal of Roentgenology, 2006, 186(6):1723-1732.
[9] Sardanelli F, Boetes C, Borisch B, et al. Magnetic resonance imaging of the breast:Recommendations from the EUSOMA working group[J]. European Journal of Cancer, 2010, 46(8):1296-1316.
[10] Bennani-Baiti B, Dietzel M, Baltzer P A, MRI for the assessment of malignancy in BI-RADS 4 mammographic microcalcifications[J]. PLoS One, 2017, 12(11):e0188679.
[11] Fiaschetti V, Pistolese C A, Perretta T, et al. 3-5 BI-RADs microcalcifications:correlation between MRI and histological findings[J]. ISRN Oncology, 2011, 2011(6):643890.
[12] Kuhl C K, Schrading S, Bieling H B, et al. MRI for diagnosis of pure ductal carcinoma in situ:a prospective observational study[J]. Lancet,2007, 370(9586):485-492.
[13] Kuhl C K. MRI of breast tumors[J]. European Radiology, 2000, 10(1):46-58.
[14] Di Giovanni P, Azlan C A, Ahearn T S, et al. The accuracy of pharmacokinetic parameter measurement in DCE-MRI of the breast at 3T[J]. Physics in Medicine and Biology, 2010, 55(1):121-132.
[15] Iglesias A, Arias M, Santiago P, et al. Benign breast lesions that simulate malignancy:magnetic resonance imaging with radiologic-pathologic correlation[J]. Current Problems in Diagnostic Radiology,2007, 36(2):66-82.
[16] Wilkinson L, Thomas V, Sharma N. Microcalcification on mammography:approaches to interpretation and biopsy[J]. British Journal of Radiology, 2016, 90(1069):20160594.
[17] Boetes C, Mus R D M, Holland R, et al.Breast tumors:comparative accuracy of MR imag ing relative to mammography and US for demonstrating extent[J].Radiology, 1995, 197(3):743-747.
[18] Sardanelli F, Giuseppetti G M, Panizza P, et al. Sensitivity of MRI versus mammography for detecting foci of multifocal, multicentric breast cancer in fatty and dense breasts using the whole-breast pathologic examination as a gold standard[J]. American Journal of Roentgenology, 2004, 183(4):1149-1157.
[19] Houserkova D, Prasad S N, Svach I, et al. The value of dynamic contrast enhanced breast MRI in mammographically detected BI-RADS 5 microcalcifications[J]. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2008, 152(1):107-115.
[20] Hansen N L, Kuhl C K, Barabasch A, et al. Does MRI breast "density" (degree of background enhancement) correlate with mammographic breast density?[J]. Journal of Magnetic Resonance Imaging, 2014, 40(2):483-489.
[21] Uematsu T, Kasami M, Watanabe J. Background enhancement of mammary glandular tissue on breast dynamic MRI:imaging features and effect on assessment of breast cancer extent[J]. Breast Cancer, 2012, 19(3):259-265.
[22] Klifa C, Suzuki S, Aliu S, et al. Quantification of background enhancement in breast magnetic resonance imaging[J]. Journal of Magnetic Resonance Imaging Jmri, 2011, 33(5):1229-1234.
[23] Jiang Y, Lou J, Wang S, et al. Evaluation of the role of dynamic contrast-enhanced MR imaging for patients with BI-RADS 3-4 microcalcifications[J]. PLoS One, 2014, 9(6):e99669.

乳腺X线摄影及动态增强MRI对BI-RADS 4-5微钙化病变的诊断价值

A Comparative Study of the Diagnostic Value of Dynamic Contrast-enhanced Magnetic Resonance Imaging and Mammography on Patients with BI-RADS 4-5 Microcalcifications

PDF (PC)

RichHTML

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 3

编辑推荐

Metrics

本文评价

[1]	胡起立, 宋黎涛, 黄松. 3.0T动态增强MRI联合fPSA/tPSA检测对前列腺癌的诊断效能[J]. 影像科学与光化学, 2020, 38(5): 871-875.
[2]	杨行, 李真林, 张雪琴, 杨吉学, 周蜀川, 刘莹, 赵爽, 袁元. 对比增强能谱乳腺X线摄影的强化特点及其对BI-RADS 4类乳腺病灶的鉴别效果[J]. 影像科学与光化学, 2020, 38(5): 876-881.
[3]	杨行, 张雪琴, 袁元, 李真林, 刘曦娇, 杨吉学, 黄林. 对比增强能谱乳腺X线摄影在致密型乳腺疾病中的诊断价值[J]. 影像科学与光化学, 2020, 38(2): 296-300.