Pediconi Federica, Venditti Fiammetta, Padula Simona, Roselli Antonella, Moriconi Enrica, Giacomelli Laura, Catalano Carlo, Passariello Roberto
Dipartimento di Scienze Radiologiche, Università degli Studi di Roma La Sapienza, Rome.
Radiol Med. 2005 Jul-Aug;110(1-2):61-8.
To evaluate the role of contrast-enhanced Magnetic Resonance Mammography (MRM) in the evaluation of the contralateral breast in patients with recently diagnosed breast cancer.
Fifty patients with proved unilateral breast cancer, with a negative contralateral breast at physical examination, ultrasound and mammography, were studied with a 1.5 T magnet (Siemens, Vision Plus, Germany). A bilateral breast surface coil was used. Dynamic 3D Flash T1-weighted sequences were acquired in the axial plane before and 0, 2, 4, 6 and 8 minutes after the administration of 0.1 mmol/kg of Gd-BOPTA at a flow rate of 2 ml/s followed by 10 ml of saline. The level of suspicion was reported on a scale from 0 to 5 following the BI-RADS classification, based on lesion morphology and kinetic features. The results were compared with the histological findings after biopsy or surgery.
Fourteen out of 50 patients (28%) had contralateral lesions identified on MRM. Biopsy was performed in four of them for suspicious lesions (BI-RADS 4) while 10 patients underwent surgery because of highly suggestive malignant lesions (BI-RADS 5). Histology diagnosed three fibroadenomas, 5 ductal carcinomas in situ, 2 lobular carcinomas in situ, 3 invasive ductal carcinomas and 1 invasive lobular carcinoma. Contrast-enhanced MRM yielded no false negative and three false positives.
Our results demonstrate a very good accuracy of Magnetic Resonance Mammography in the detection of synchronous contralateral cancer in patients with newly diagnosed breast cancer. Therefore, contrast-enhanced MRM could be introduced to screen patients with proven breast cancer before they undergo surgery.
评估对比增强磁共振乳腺成像（MRM）在近期诊断为乳腺癌患者对侧乳腺评估中的作用。
对50例经证实为单侧乳腺癌且体格检查、超声及乳腺X线摄影显示对侧乳腺阴性的患者，使用1.5T磁共振成像仪（德国西门子公司，Vision Plus）进行研究。采用双侧乳腺表面线圈。在注射0.1mmol/kg钆布醇（Gd-BOPTA）前及注射后0、2、4、6和8分钟，以2ml/s的流速注射，随后注射10ml生理盐水，在轴位平面采集动态三维快速扰相梯度回波（Flash）T1加权序列。根据病变形态和动力学特征，按照乳腺影像报告和数据系统（BI-RADS）分类，将可疑程度报告为0至5级。将结果与活检或手术后的组织学结果进行比较。
50例患者中有14例（28%）在MRM上发现对侧病变。其中4例因可疑病变（BI-RADS 4级）进行了活检，10例因高度可疑恶性病变（BI-RADS 5级）接受了手术。组织学诊断为3例纤维腺瘤、5例导管原位癌、2例小叶原位癌、3例浸润性导管癌和1例浸润性小叶癌。对比增强MRM未出现假阴性结果，有3例假阳性结果。
我们的结果表明，磁共振乳腺成像在检测新诊断乳腺癌患者的同步对侧癌方面具有很高的准确性。因此，在已证实患有乳腺癌的患者接受手术前，可引入对比增强MRM进行筛查。
