Eliahou Ruth, Sella Tamar, Allweis Tanir, Samet Yaacov, Libson Eugene, Sklair-Levy Miri
Department of Radiology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Isr Med Assoc J. 2009 May;11(5):275-9.
Magnetic resonance imaging of the breast has emerged as a valuable imaging tool in addition to conventional imaging modalities. It has high sensitivity for malignant lesions and can detect mammographically, sonographically and clinically occult cancers. "MR only" lesions are best biopsied under MR guidance; however, this may be a challenging task.
To evaluate our initial clinical experience with MR-guided core needle breast biopsy and MR-guided needle localization.
We retrospectively evaluated 81 women with 97 lesions, who were scheduled for guided core needle biopsy or MR-guided needle localization followed by surgery. Lesions were categorized as malignant, high risk, or benign according to the BI-RADS MR classification system. MR findings were compared with final histopathology or with follow-up imaging findings.
Fifteen (16%) lesions were malignant (9 invasive ductal carcinoma, 2 invasive lobular carcinoma, 4 ductal carcinoma in situ); 7 (7%) lesions were high risk (4 atypical ductal hyperplasia, 3 radial scars); 75 (77%) lesions were benign, mainly fibrocystic changes. Other benign findings were sclerosing adenosis, pseudoangiomatous stromal hyperplasia, fat necrosis, intraductal papilloma, fibroadenoma, capillary hemangioma, and florid ductal hyperplasia. No major complications were encountered.
MR-guided interventional procedures of the breast are accurate, safe and feasible methods for sampling breast lesions detected only by MR and have become a significant tool in the management of certain patients.
除传统成像方式外，乳腺磁共振成像已成为一种有价值的成像工具。它对恶性病变具有高敏感性，能够检测出乳腺钼靶、超声及临床隐匿性癌症。“仅磁共振成像发现”的病变最好在磁共振引导下进行活检；然而，这可能是一项具有挑战性的任务。
评估我们在磁共振引导下乳腺粗针活检和磁共振引导下针定位方面的初步临床经验。
我们回顾性评估了81例患有97个病变的女性，她们计划接受引导下粗针活检或磁共振引导下针定位，随后进行手术。根据BI-RADS磁共振分类系统，将病变分为恶性、高风险或良性。将磁共振成像结果与最终组织病理学结果或随访成像结果进行比较。
15个（16%）病变为恶性（9例浸润性导管癌、2例浸润性小叶癌、4例导管原位癌）；7个（7%）病变为高风险（4例非典型导管增生、3例放射状瘢痕）；75个（77%）病变为良性，主要为纤维囊性变。其他良性表现包括硬化性腺病、假血管瘤样间质增生、脂肪坏死、导管内乳头状瘤、纤维腺瘤、毛细血管瘤和旺炽性导管增生。未出现重大并发症。
乳腺磁共振引导下介入操作是对仅通过磁共振成像检测到的乳腺病变进行取样的准确、安全且可行的方法，已成为某些患者管理中的重要工具。
