Jiang Yanni, Lou Jianjuan, Wang Siqi, Zhao Yi, Wang Cong, Wang Dehang
Division of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Division of Breast Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
PLoS One. 2014 Jun 13;9(6):e99669. doi: 10.1371/journal.pone.0099669. eCollection 2014.
The purpose of study was to prospectively evaluate the diagnostic performance of dynamic contrast-enhanced MR imaging in the differentiation of malignant lesions from benign ones in patients with BI-RADS 3-4 microcalcifications detected by mammography.
93 women with 100 microcalcifications had undergone breast MRI from June 2010 to July 2013. Subsequently, 91 received open biopsy and 2 received stereotactic vacuum-assisted biopsy. All results were compared with histological findings. The PPV, NPV and area under curve (AUC) of the mammography and breast MRI were calculated.
There were 31 (31.0%) BI-RADS 3 microcalcifications and 69 (69.0%) BI-RADS 4. The PPV and NPV of mammography is 65.2% (45/69) and 90.3% (28/31). The PPV and NPV of breast MRI was 90.2% (46/51) and 95.9% (47/49). Among 31 BI-RADS 3 microcalcifications, the PPV and NPV of breast MRI was 100% (3/3) and 100% (28/28). Among 69 BI-RADS 4 microcalcifications, the PPV and NPV of breast MRI was 89.6% (43/48) and 90.5% (19/21). The AUC of mammography and breast MRI assessment were 0.738 (95% CI, 0.639-0.837) and 0.931 (95% CI, 0.874-0.988) (p<0.05).
Dynamic contrast-enhanced MR imaging of breast is able to be applied to predict the risk of malignance before follow-up for BI-RADS 3 microcalcifications and biopsy for BI-RADS 4 microcalcifications.
本研究的目的是前瞻性评估动态对比增强磁共振成像在鉴别乳腺钼靶检查发现的BI-RADS 3-4级微钙化患者的恶性病变与良性病变中的诊断性能。
2010年6月至2013年7月,93例有100处微钙化的女性接受了乳腺MRI检查。随后,91例接受了开放活检,2例接受了立体定向真空辅助活检。所有结果均与组织学结果进行比较。计算乳腺钼靶检查和乳腺MRI的阳性预测值(PPV)、阴性预测值(NPV)和曲线下面积(AUC)。
有31处(31.0%)BI-RADS 3级微钙化和69处(69.0%)BI-RADS 4级微钙化。乳腺钼靶检查的PPV和NPV分别为65.2%(45/69)和90.3%(28/31)。乳腺MRI的PPV和NPV分别为90.2%(46/51)和95.9%(47/49)。在31处BI-RADS 3级微钙化中,乳腺MRI的PPV和NPV分别为100%(3/3)和100%(28/28)。在69处BI-RADS 4级微钙化中,乳腺MRI的PPV和NPV分别为89.6%(43/48)和90.5%(19/21)。乳腺钼靶检查和乳腺MRI评估的AUC分别为0.738(95%CI,0.639-0.837)和0.931(95%CI,0.874-0.988)(p<0.05)。
乳腺动态对比增强磁共振成像能够用于预测BI-RADS 3级微钙化随访前和BI-RADS 4级微钙化活检前的恶性风险。