Chang Yun-Woo, Kwon Kui Hyang, Choi Deuk Lin, Lee Dong Wha, Lee Min Hyuk, Lee Hye Kyung, Yang Seung Boo, Kim Yongbae, Seo Dae Young
Departments of Radiology, College of Medicine, Soonchunhyang University Hospital, Seoul, Korea.
Acta Radiol. 2009 Nov;50(9):990-8. doi: 10.3109/02841850903225180.
Prognostic factors of breast cancer have been used for the prediction of clinical outcome or selection of patients for complementary treatment. Some of the imaging features of breast cancer, e.g. magnetic resonance imaging (MRI), are associated with these prognostic factors.
To evaluate the relationship between dynamic enhanced MR features and prognostic factors of clinical outcome of breast cancer.
A total of 136 patients with 151 breast cancers underwent 1.5T dynamic MR imaging with the use of a dynamic T1-weighted three-dimensional fast low-angle shot (FLASH) subtraction imaging technique. Morphological and kinetic analyses of MR features were evaluated using the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) MRI lexicon. Pathological prognostic factors were correlated with MR imaging characteristics, including tumor size, histological grade, lymph node status, expression of estrogen receptor (ER), expression of progesterone receptor (PR), expression of c-erbB2, determination of Ki-67 index, and microvascular density (MVD), using univariate and multivariate statistical analyses.
Based on univariate and multivariate analyses, spiculated tumor margins correlated significantly with lower histological grade (I-II) and positive PR expression. Rim enhancement was significantly correlated with high histological grade, presence of axillary lymph node metastasis, large tumor size, increased Ki-67 index, and increased MVD. Early peak enhancement, as seen on the first scan after contrast medium injection, was correlated with negative ER expression.
The presence of a lesion with a spiculated margin may predict a relatively good prognosis, and the presence of a lesion with rim enhancement may predict a relatively poor prognosis.
乳腺癌的预后因素已被用于预测临床结局或选择患者进行辅助治疗。乳腺癌的一些影像学特征，如磁共振成像（MRI），与这些预后因素相关。
评估动态增强磁共振成像（MR）特征与乳腺癌临床结局预后因素之间的关系。
136例患有151个乳腺癌的患者接受了1.5T动态MR成像，采用动态T1加权三维快速低角度激发（FLASH）减影成像技术。使用美国放射学会（ACR）乳腺影像报告和数据系统（BI-RADS）MRI词典对MR特征进行形态学和动力学分析。通过单变量和多变量统计分析，将病理预后因素与MR成像特征相关联，这些特征包括肿瘤大小、组织学分级、淋巴结状态、雌激素受体（ER）表达、孕激素受体（PR）表达、c-erbB2表达、Ki-67指数测定和微血管密度（MVD）。
基于单变量和多变量分析，毛刺状肿瘤边缘与较低的组织学分级（I-II级）和PR阳性表达显著相关。边缘强化与高组织学分级、腋窝淋巴结转移、肿瘤体积大、Ki-67指数增加和MVD增加显著相关。在注射造影剂后的第一次扫描中出现的早期峰值强化与ER阴性表达相关。
边缘呈毛刺状的病变可能预示预后相对较好，而边缘强化的病变可能预示预后相对较差。
