Winnekendonk G, Krug B, Warm M, Göhring U-J, Mallmann P, Lackner K
Institut und Poliklinik für Radiologische Diagnostik der Universität zu Köln.
Rofo. 2004 May;176(5):688-93. doi: 10.1055/s-2004-813119.
To evaluate preoperative contrast enhanced MR imaging in clinically, mammographically and/or ultrasonographically established breast cancer.
From September 1998 to August 1999, preoperative contrast-enhanced MR imaging of the breast was performed in 91 patients with lesions highly suggestive of malignancy (BIRADS IV and V) by clinical, mammographic, and/or ultrasonographic criteria. MR imaging findings were postsurgically correlated with other imaging, intraoperative and histopathologic results.
Histopathologic analysis revealed 61 (66 %) malignant and 31 (34 %) benign lesions. In 63 (69 %) of the 91 investigated patients, MR mammographies were classified as tumor suspect and in the remaining 28 (31 %) cases as benign. The sensitivity, specificity and accuracy were 90 %, 67 % and 81 % for contrast-enhanced MR imaging. Additional tumor manifestations (multifocal or multicentric disease, contralateral carcinoma) were found by MR imaging alone in 10 patients (11 %).
Contrast-enhanced MR imaging may reveal unsuspected multifocal, multicentric or contralateral breast carcinoma that changes the surgical therapy if the intention is total tumor removal. The prognostic role of a potentially more radical surgical therapy on the basis of these findings is not clear.
评估术前对比增强磁共振成像（MRI）在临床、乳腺钼靶和/或超声检查确诊的乳腺癌中的应用价值。
1998年9月至1999年8月，对91例经临床、乳腺钼靶和/或超声检查高度怀疑为恶性病变（乳腺影像报告和数据系统[BIRADS]IV和V级）的患者进行了术前乳腺对比增强MRI检查。术后将MRI检查结果与其他影像学检查、术中及组织病理学结果进行对比分析。
组织病理学分析显示，恶性病变61例（66%），良性病变31例（34%）。在91例受检患者中，63例（69%）的MRI乳腺造影被判定为可疑肿瘤，其余28例（31%）为良性。对比增强MRI的敏感性、特异性和准确性分别为90%、67%和81%。仅通过MRI检查发现另外10例患者（11%）存在额外的肿瘤表现（多灶性或多中心性病变、对侧癌）。
如果旨在完全切除肿瘤，对比增强MRI可能会发现未被怀疑的多灶性、多中心性或对侧乳腺癌，从而改变手术治疗方案。基于这些发现进行的可能更为彻底的手术治疗的预后作用尚不清楚。
