对比增强乳腺MRI检查中的BI-RADS® 3类病变：是否需要进行初始短期随访？
BI-RADS® 3 lesions at contrast-enhanced breast MRI: is an initial short-interval follow-up necessary?
作者信息
Bahrs Sonja D, Baur Astrid, Hattermann Valerie, Hahn Markus, Vogel Ulrich, Claussen Claus D, Siegmann-Luz Katja C
机构信息
Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tuebingen, Germany.
出版信息
Acta Radiol. 2014 Apr;55(3):260-5. doi: 10.1177/0284185113501304. Epub 2013 Aug 22.
BACKGROUND
Magnetic resonance imaging (MRI) BI-RADS® 3 lesions should have a very high probability of being benign. To prove benignity most institutions do follow-up MRI.
PURPOSE
To evaluate the necessity of initial short-interval follow-up after 6 months as it is suggested for mammographic BI-RADS®3 lesions.
MATERIAL AND METHODS
We analyzed 163 consecutive MRI-BI-RADS® 3 lesions on follow-up MRI: 75 masses (46%), 67 foci (41.1%), and 21 (12.9%) non-mass-like enhancing lesions (NMLE).
RESULTS
During MRI follow-up (mean time, 563 days) 20% of the lesions disappeared, 23% decreased, 52% did not change, and 4.9% showed increase. All increasing lesions were biopsied (5 benign, 2 ductal carcinoma in situ, 1 invasive carcinoma). The rate of malignancy was 1.8%. All malignant lesions (1 mass, 1 focus, 1 NMLE) showed increase at initial follow-up after a mean interval of 190 days.
CONCLUSION
In this study the malignancy rate of MRI-BI-RADS® 3 lesions corresponded to mammographic BI-RADS® 3 lesions. Initial short-interval MRI should be suggested to identify malignant MRI-BI-RADS® 3 lesions.
背景
磁共振成像（MRI）BI-RADS® 3类病变极有可能为良性。为证实其良性，大多数机构会进行MRI随访。
目的
评估是否有必要像乳腺钼靶BI-RADS® 3类病变那样在6个月后进行首次短期随访。
材料与方法
我们分析了163例连续的MRI-BI-RADS® 3类病变的随访MRI检查结果：75个肿块（46%），67个病灶（41.1%），以及21个（12.9%）非肿块样强化病变（NMLE）。
结果
在MRI随访期间（平均时间为563天），20%的病变消失，23%缩小，52%无变化，4.9%增大。所有增大的病变均接受了活检（5例良性，2例导管原位癌，1例浸润性癌）。恶性率为1.8%。所有恶性病变（1个肿块，1个病灶，1个NMLE）在首次随访时均增大，平均间隔时间为190天。
结论
在本研究中，MRI-BI-RADS® 3类病变的恶性率与乳腺钼靶BI-RADS® 3类病变相当。应建议进行首次短期MRI检查以识别恶性的MRI-BI-RADS® 3类病变。
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