患有和未患有乳腺癌的患者在检查期间实质背景强化情况。
Background parenchymal enhancement over exam time in patients with and without breast cancer.
作者信息
Melsaether Amy, Pujara Akshat C, Elias Kristin, Pysarenko Kristine, Gudi Anjali, Dodelzon Katerina, Babb James S, Gao Yiming, Moy Linda
机构信息
Department of Radiology, NYU Perlmutter Cancer Center, New York University School of Medicine, New York, New York, USA.
Department of Radiology, Center for Advanced Imaging Innovation and Research (CAI(2)R), New York University School of Medicine, New York, New York, USA.
出版信息
J Magn Reson Imaging. 2017 Jan;45(1):74-83. doi: 10.1002/jmri.25338. Epub 2016 Jun 10.
PURPOSE
To compare background parenchymal enhancement (BPE) over time in patients with and without breast cancer.
MATERIALS AND METHODS
This retrospective Institutional Review Board (IRB)-approved, Health Insurance Portability and Accountability Act (HIPAA)-compliant study included 116 women (25-84 years, mean 54 years) with breast cancer who underwent breast magnetic resonance imaging at 3T between 1/2/2009 and 12/29/2009 and 116 age and date-of-exam-matched women without breast cancer (23-84 years, mean 51 years). Two independent, blinded readers (R1, R2) recorded BPE (minimal, mild, moderate, marked) at three times (100, 210, and 320 seconds postcontrast). Subsequent cancers were diagnosed in 9/96 control patients with follow up (12.6-93.0 months, mean 63.6 months). Exact Mann-Whitney, Fisher's exact, and McNemar tests were performed.
RESULTS
Mean BPE was not found to be different between patients with and without breast cancer at any time (P = 0.36-0.64). At time 2 as compared with time 1, there were significantly more patients, both with and without breast cancer, with BPE >minimal (R1: 90 vs. 41 [P < 0.001] and 81 vs. 36 [P < 0.001]; R2: 84 vs. 52 [P < 0.001] and 79 vs. 43 [P < 0.001]) and BPE >mild (R1: 59 vs. 10 [P < 0.001] and 47 vs. 13 [P < 0.001]; R2: 49 vs. 12 [P < 0.001] and 41 vs. 18 [P < 0.001]). BPE changes between times 2 and 3 were not significant (P = 0.083-1.0). Odds ratios for control patients developing breast cancer were significant only for R2 and ranged up to 7.67 (1.49, 39.5; P < 0.01) for BPE >mild at time 2.
CONCLUSION
BPE changes between the first and second postcontrast scans and stabilizes thereafter in most patients. Further investigation into the most clinically relevant timepoint for BPE assessment is warranted.
LEVEL OF EVIDENCE
3 J. Magn. Reson. Imaging 2017;45:74-83.
目的
比较患有和未患乳腺癌患者的背景实质强化（BPE）随时间的变化情况。
材料与方法
这项经机构审查委员会（IRB）批准的回顾性研究符合《健康保险流通与责任法案》（HIPAA）规定，纳入了116例患有乳腺癌的女性（年龄25 - 84岁，平均54岁），她们于2009年1月2日至2009年12月29日期间在3T场强下接受了乳腺磁共振成像检查，以及116例年龄和检查日期匹配的未患乳腺癌的女性（年龄23 - 84岁，平均51岁）。两名独立的、不知情的阅片者（R1、R2）在三个时间点（注射造影剂后100、210和320秒）记录BPE（轻微、轻度、中度、显著）。96例对照患者中有9例在随访期间（12.6 - 93.0个月，平均63.6个月）被诊断出后续发生了癌症。进行了精确的曼 - 惠特尼检验、费舍尔精确检验和麦克尼马尔检验。
结果
在任何时间点，患有和未患乳腺癌的患者之间平均BPE均无差异（P = 0.36 - 0.64）。与时间点1相比，在时间点2时，患有和未患乳腺癌的患者中，BPE＞轻微的患者显著增多（R1：90例对41例[P ＜0.001]和81例对36例[P ＜0.001]；R2：84例对52例[P ＜0.001]和79例对43例[P ＜0.001]）以及BPE＞轻度的患者显著增多（R1：59例对10例[P ＜0.001]和47例对13例[P ＜0.001]；R2：49例对12例[P ＜0.001]和41例对18例[P ＜0.001]）。时间点2和时间点3之间的BPE变化不显著（P = 0.083 - 1.0）。对照患者发生乳腺癌的优势比仅在R2时有显著意义，在时间点2时，对于BPE＞轻度的情况，优势比高达7.67（1.49，39.5；P ＜0.01）。
结论
在大多数患者中，BPE在首次和第二次注射造影剂后的扫描之间发生变化，此后趋于稳定。有必要进一步研究BPE评估最具临床相关性的时间点。
证据级别
3 J. Magn. Reson. Imaging 2017;45:74 - 83.
Zotero 插件