Dipartimento di Radiologia, Policlinico Universitario "G.B. Rossi", P.le L.A. Scuro 10, 37134 Verona, Italy.
Radiol Med. 2011 Sep;116(6):876-85. doi: 10.1007/s11547-011-0631-7. Epub 2011 Feb 1.
The objective of this study was to determine the clinical value and accuracy of magnetic resonance (MR)-guided vacuum-assisted breast biopsy (VAB).
We retrospectively analysed 106 incidental breast lesions detected on MR imaging in 98 patients. Patients with nonpalpable suspicious lesions that were only MR visible were referred for MR-VAB performed with a 10-gauge needle. All patients with a VAB diagnosis of infiltrating carcinoma, carcinoma in situ or atypical epithelial hyperplasia were referred for surgery. Histopathology of the surgical specimen was considered the reference standard.
MR-guided VAB was attempted in 29/106 lesions (27%); in 2/29 patients, the procedure could not be performed owing to failure to visualise the lesion. Lesions with clearly malignant features and borderline lesions (atypical ductal hyperplasias) were identified in 12 cases (44%) and benign entities in 15 (56%). Seven of 12 (58%) malignant lesions were <10 mm. Among the 27 successful MR-VAB procedures, VAB yielded one false-negative diagnosis (4%) and underestimation (4%). MR-guided VAB sensitivity and specificity were 92% and 100%, respectively, with a positive predictive value of 100% and a negative predictive value of 93%.
The results of this study indicate that MR-guided VAB offers good accuracy in characterising nonpalpable breast lesions visible on MR imaging alone. Small lesion size (<1 cm) did not prove to be a limitation for the success of the procedure.
本研究旨在确定磁共振（MR）引导下真空辅助乳腺活检（VAB）的临床价值和准确性。
我们回顾性分析了 98 例患者 106 例偶然发现的乳腺病变的 MR 成像结果。对仅在 MR 上可见的不可触及的可疑病变患者进行 MR-VAB 检查，使用 10 号针进行。所有 VAB 诊断为浸润性癌、原位癌或非典型上皮增生的患者均被转诊接受手术治疗。以手术标本的组织病理学为参考标准。
29/106 例（27%）尝试进行了 MR 引导下 VAB；29 例患者中有 2 例（7%）因无法观察到病变而无法进行该操作。12 例（44%）患者发现具有明确恶性特征和交界性病变（非典型导管增生），15 例（56%）患者发现良性病变。12 例恶性病变中有 7 例（58%）<10mm。在 27 例成功的 MR-VAB 操作中，VAB 有 1 例（4%）假阴性和低估（4%）。MR 引导下 VAB 的敏感性和特异性分别为 92%和 100%，阳性预测值为 100%，阴性预测值为 93%。
本研究结果表明，MR 引导下 VAB 对单独在 MR 成像上可见的不可触及的乳腺病变具有良好的准确性。小病变大小（<1cm）并未成为该操作成功的限制因素。
