Kneeshaw P J, Lowry M, Manton D, Hubbard A, Drew P J, Turnbull L W
Academic Surgical Unit, Castle Hill Hospital, Cottingham, Hull, UK.
Breast. 2006 Feb;15(1):29-38. doi: 10.1016/j.breast.2005.05.002. Epub 2005 Jul 5.
Dynamic Contrast Enhanced Magnetic Resonance Imaging (DCE-MRI) is an effective diagnostic modality for symptomatic breast disease. However, its role 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.
动态对比增强磁共振成像（DCE-MRI）是一种用于有症状乳腺疾病的有效诊断方法。然而，其在评估与乳腺钼靶检测到的微钙化相关的临床隐匿性疾病中的作用仍不明确。在乳腺钼靶筛查中因微钙化被召回的女性接受了乳腺DCE-MRI检查。使用经验性和双室药代动力学建模技术对数据进行主观和客观评估，以评估信号强度参数。招募了88名年龄在50 - 75岁（中位数58岁）的患者。比较恶性和良性病变，在增强最明显的9像素正方形区域1分钟时增强指数的任意单位平均值±1标准差为0.61±0.40 vs. 0.22±0.26，p<0.001，敏感性、特异性、阳性预测值、阴性预测值和准确性分别为80.0%、82.4%、57.1%、93.3%和81.8%。放射科医生得出的相应值分别为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恶性和良性病变，因此对于在乳腺微钙化初次三联评估后结果不明确的女性，可能是开放手术活检的一种替代方法。
