Department of Radiology, Massachusetts General Hospital, Institute for Technology Assessment, 101 Merrimac Street, 10(th) Floor, Boston, MA 02114, USA.
Acad Radiol. 2009 Nov;16(11):1323-8. doi: 10.1016/j.acra.2009.05.011. Epub 2009 Jul 25.
Breast magnetic resonance imaging (MRI) is increasingly being added to mammography for screening asymptomatic women at increased risk of breast cancer. Because the direction and extent of correlation between mammography and MRI could potentially result in over- or underestimation of the diagnostic gain related to using MRI as an adjunct to mammographic screening, we performed an analysis to evaluate the extent of correlation between mammography and MRI.
We reviewed the published literature to identify multimodality breast cancer screening studies reporting the sensitivity of mammography and MRI, alone and in combination, for breast cancer diagnosis. After calculating the expected sensitivity of combined mammography and MRI under conditions of test independence (no correlation), we compared the calculated and observed sensitivities for combined mammography and MRI. We then calculated correlation coefficients for mammography and MRI.
Seven studies of multimodality screening in women at increased risk of developing breast cancer were included for analysis. Of these studies, the correlation between film mammography and MRI was positive in three studies, negative in two studies, and not identified in two studies. The calculated correlation coefficients ranged from -0.38 to 0.18. In six of seven studies, the 95% confidence interval for the correlation coefficient included 0.0, indicating no significant correlation.
Evidence from published trials of multimodality breast cancer screening identified no statistically significant correlation between film mammography and MRI. Using both tests for breast cancer screening is likely to improve the early detection of breast cancer in women at increased risk.
乳腺磁共振成像（MRI）越来越多地被应用于乳腺癌高危无症状女性的筛查中，作为乳腺 X 线摄影的辅助手段。由于乳腺 X 线摄影与 MRI 之间的相关性的方向和程度可能导致对使用 MRI 作为乳腺 X 线摄影筛查辅助手段相关的诊断增益的高估或低估，因此我们进行了一项分析，以评估乳腺 X 线摄影与 MRI 之间的相关性程度。
我们查阅了已发表的文献，以确定报道了乳腺 X 线摄影和 MRI 单独及联合用于乳腺癌诊断的灵敏度的多模态乳腺癌筛查研究。在计算出联合应用乳腺 X 线摄影和 MRI 时（无相关性）的预期灵敏度后，我们比较了联合应用乳腺 X 线摄影和 MRI 的计算灵敏度和观察灵敏度。然后我们计算了乳腺 X 线摄影和 MRI 的相关系数。
纳入了 7 项针对高乳腺癌发病风险女性的多模态筛查研究进行分析。在这 7 项研究中，有 3 项研究中乳腺 X 线摄影与 MRI 之间的相关性为正，2 项研究为负，2 项研究未确定。计算的相关系数范围为-0.38 至 0.18。在 7 项研究中的 6 项中，相关系数的 95％置信区间包括 0.0，表明无显著相关性。
来自多模态乳腺癌筛查的已发表试验证据表明，乳腺 X 线摄影与 MRI 之间没有统计学显著相关性。使用这两种检查方法进行乳腺癌筛查可能会提高高危女性的乳腺癌早期检出率。
