Kim Soo-Yeon, Lee Hye Sun, Kim Eun-Kyung, Kim Min Jung, Moon Hee Jung, Yoon Jung Hyun
Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Korea; Department of Radiology, Seoul National University Hospital, Seoul, Korea.
Biostatistics Collaboration Unit, Yonsei University, College of Medicine, Seoul, Korea.
Ultrasound Med Biol. 2016 Dec;42(12):2766-2774. doi: 10.1016/j.ultrasmedbio.2016.08.008. Epub 2016 Sep 19.
Background parenchymal enhancement (BPE) on breast magnetic resonance imaging (MRI) may either obscure or mimic malignancy. We evaluated the impact of BPE on the diagnostic performance of pre-operative MRI in breast cancer patients, and how second-look ultrasound (US) can help in guiding patient management. Two hundred fifty-three breast cancer patients with pre-operative MRI were included. In moderate or marked BPE, abnormal interpretation rate (38.9% vs. 12.2%) and biopsy rate (27.8% vs. 8.3%) were higher, and specificity (64.7% vs. 89.8%) was lower, compared with minimal or mild BPE (all p < 0.001). Visibility of MRI-detected additional suspicious lesions on second-look US did not differ between the two groups (86.7% in minimal or mild BPE vs. 77.1% in moderate or marked BPE, p = 0.296). Increased BPE was related to increased abnormal interpretation rate, additional biopsy rate and decreased specificity. Second-look US was useful in visualization of MRI-detected additional suspicious lesions, regardless of BPE.
乳腺磁共振成像（MRI）中的背景实质强化（BPE）可能会掩盖或模拟恶性肿瘤。我们评估了BPE对乳腺癌患者术前MRI诊断性能的影响，以及二次超声检查（US）如何有助于指导患者管理。纳入了253例术前行MRI检查的乳腺癌患者。与轻度或无BPE相比，中度或显著BPE时的异常解读率（38.9%对12.2%）和活检率（27.8%对8.3%）更高，而特异性（64.7%对89.8%）更低（所有p<0.001）。两组间二次超声检查时MRI检测到的额外可疑病变的可视性无差异（轻度或无BPE组为86.7%，中度或显著BPE组为77.1%，p=0.296）。BPE增加与异常解读率增加、额外活检率增加及特异性降低相关。无论BPE情况如何，二次超声检查对于可视化MRI检测到的额外可疑病变均有用。
