Perfetto F, Fiorentino F, Urbano F, Silecchia R
Azienda Ospedaliero-Universitaria OO.RR., Ospedali Riuniti, Foggia, Italy.
Radiol Med. 2009 Aug;114(5):757-70. doi: 10.1007/s11547-009-0405-7. Epub 2009 May 30.
We sought to identify breast magnetic resonance imaging (MRI) criteria capable of influencing the differential diagnosis between radial scars related to benign proliferative disease and those associated with breast cancer with a view to proposing breast MRI as a promising and cost-effective modality to be carried out between mammography and surgical biopsy.
From 1998 to June 2006, we studied 20 patients with a focal architectural distortion on mammography. All patients underwent contrast-enhanced breast MRI with a T1 Philips Gyroscan scanner and the acquisition of T1-weighted fast field echo, echo planar imaging (FFE EPI) axial dynamic sequences with a slice thickness of 3 mm. During postprocessing, subtracted images were assessed for morphological features, pattern of contrast enhancement, time-intensity curve and lesion enhancement rate.
Breast MRI depicted 27 lesions between 7 mm and 30 mm in size. Fifteen of the 27 breast lesions showed benign features, eight showed malignant features and four were classified as suspicious. Pathological examination confirmed the benignity of all 15 lesions showing benign MRI features and revealed the benign nature of the four lesions classified as suspicious.
Evaluation of breast MRI showed that enhancement rate and time-intensity curve were useful only in the differential diagnosis between benign and malignant breast lesions. Our experience confirmed that breast MRI has very high sensitivity and, in particular, a negative predictive value of 100%. Breast MRI could thus be considered a useful diagnostic tool that can guide the choice between follow-up or surgical excision of radial scars.
我们试图确定能够影响与良性增生性疾病相关的放射状瘢痕和与乳腺癌相关的放射状瘢痕之间鉴别诊断的乳腺磁共振成像（MRI）标准，以期将乳腺MRI作为一种有前景且具成本效益的检查方式，用于在乳腺X线摄影和手术活检之间进行。
1998年至2006年6月，我们研究了20例乳腺X线摄影显示局灶性结构扭曲的患者。所有患者均使用飞利浦Gyroscan T1扫描仪进行对比增强乳腺MRI检查，并采集层厚3 mm的T1加权快速场回波、回波平面成像（FFE EPI）轴向动态序列。在图像后处理过程中，对减影图像评估其形态特征、对比增强模式、时间-强度曲线和病变增强率。
乳腺MRI显示27个大小在7 mm至30 mm之间的病变。27个乳腺病变中，15个显示良性特征，8个显示恶性特征，4个被归类为可疑。病理检查证实所有15个显示良性MRI特征的病变均为良性，并揭示了4个被归类为可疑病变的良性性质。
乳腺MRI评估显示，增强率和时间-强度曲线仅在乳腺良恶性病变的鉴别诊断中有用。我们的经验证实，乳腺MRI具有非常高的敏感性，尤其是阴性预测值为100%。因此，乳腺MRI可被视为一种有用的诊断工具，可指导对放射状瘢痕进行随访或手术切除的选择。
