1 Department of Radiology, University of Chicago, Chicago, IL.
AJR Am J Roentgenol. 2013 Nov;201(5):1155-63. doi: 10.2214/AJR.12.9707.
The purpose of this article is to evaluate the nature of breast cancers detected in the incident round of screening MRI to determine MRI features of early breast cancer.
From 2003 to 2012, there were 16 incident breast cancers in 15 patients on screening MRI, including nine cancers that were retrospectively identifiable on the prior MRI (false-negative [FN] cancers at prior screening examination). We evaluated the BI-RADS features of these incident cancers in previous and current MRI scans.
Of 16 incident cancers, there were 11 mass lesions (69%), three foci (19%), and two nonmasslike enhancement lesions (13%). Of the nine FN cancers (five foci, two masses, and two nonmasslike enhancement lesions), all showed increases in size on the current examination (median, 80% increase); four lesions showed rapid uptake kinetics on prior examinations, and five lesions showed a change in kinetic pattern from slow to rapid uptake. Among the five foci, one focus was isolated and four foci were in a background of other foci, where two foci could be distinguished for their higher signal intensity.
On screening MRI, any lesion that increases in size, has rapid uptake kinetics or a change in kinetic pattern, or is an isolated focus or focus showing more enhancement than other foci should be viewed with a high degree of suspicion, and a biopsy should be considered.
本文旨在评估筛查 MRI 中检出的乳腺癌的性质，以确定早期乳腺癌的 MRI 特征。
2003 年至 2012 年，15 例患者的筛查 MRI 共检出 16 例偶发乳腺癌，包括 9 例先前 MRI 可识别的癌症（先前筛查检查中的假阴性[FN]癌症）。我们评估了这些偶发癌症在前次和本次 MRI 扫描中的 BI-RADS 特征。
16 例偶发癌症中，有 11 例为肿块病变（69%），3 例为局灶性病变（19%），2 例为非肿块样强化病变（13%）。在 9 例 FN 癌症中（5 例局灶性病变、2 例肿块、2 例非肿块样强化病变），所有病灶在本次检查中均显示出大小增加（中位数增加 80%）；4 个病灶在先前检查中显示出快速摄取动力学，5 个病灶显示出从缓慢摄取动力学向快速摄取动力学的变化。在 5 个局灶性病变中，1 个病灶为孤立性，4 个病灶为其他局灶性病变的背景下，其中 2 个病灶因其信号强度较高而可区分。
在筛查 MRI 中，任何大小增加、摄取动力学快速或动力学模式改变、孤立性病灶或比其他病灶增强更明显的病灶，都应高度怀疑，并考虑进行活检。
