Watanabe Rie, Ando Takahito, Osawa Manami, Ido Mirai, Kousaka Junko, Mouri Yukako, Fujii Kimihito, Nakano Shogo, Kimura Junko, Ishiguchi Tsuneo, Yoshida Miwa, Imai Tsuneo, Fukutomi Takashi
Division of Breast and Endocrine Surgery, Department of Surgery, Aichi Medical University, Nagakute, Japan; Department of Breast Surgery, Yodogawa Christian Hospital, Osaka, Japan.
Division of Breast and Endocrine Surgery, Department of Surgery, Aichi Medical University, Nagakute, Japan.
Ultrasound Med Biol. 2017 Oct;43(10):2362-2371. doi: 10.1016/j.ultrasmedbio.2017.04.024. Epub 2017 Jun 27.
Our aim was to retrospectively evaluate the utility of second-look ultrasound (US) using real-time virtual sonography (RVS) for detection of conventional B-mode (cB-mode) occult magnetic resonance imaging (MRI)-detected breast lesions. Between July 2011 and May 2015, 53 consecutive patients who underwent second-look US to identify lesions detected by prone MRI were enrolled in this study. Second-look US using RVS was performed for cB-mode occult MRI-detected breast lesions after an additional supine MRI. In the 53 patients, 59 lesions were initially detected by prone MRI, followed by second-look US. Of the 59 lesions, 20 (34%) were identified by second-look US using cB-mode. Of the 39 (66%) cB-mode occult lesions, 38 (97%) were detected in supine MRI and 33 (85%) were detected by second-look US using RVS. MRI morphology types of the 33 lesions were as follows: mass, 16; non-mass enhancement, 5; and focus, 12. US-guided biopsy under RVS or excisional biopsy demonstrated that of the 33 lesions, 8 (24%) were malignant and the remaining 25 (76%) were benign. A total of 53 (90%) MRI-detected lesions were sonographically identified using both cB-mode and RVS (p < 0.001). All five remaining US-occult lesions could be followed up under RVS after the enhancing area was marked on the breast surface using RVS. Although further prospective studies are required, the findings of our pilot study suggest that second-look US using RVS with additional supine MRI may improve the sonographic and histopathologic detection rate of cB-mode occult MRI-detected breast lesions.
我们的目的是回顾性评估使用实时虚拟超声（RVS）的二次超声检查（US）在检测传统B型（cB型）隐匿性磁共振成像（MRI）检测到的乳腺病变中的效用。在2011年7月至2015年5月期间，本研究纳入了53例连续接受二次超声检查以识别俯卧位MRI检测到的病变的患者。在额外的仰卧位MRI后，对cB型隐匿性MRI检测到的乳腺病变进行使用RVS的二次超声检查。在这53例患者中，最初通过俯卧位MRI检测到59个病变，随后进行二次超声检查。在这59个病变中，20个（34%）通过使用cB型的二次超声检查得以识别。在39个（66%）cB型隐匿性病变中，38个（97%）在仰卧位MRI中被检测到，33个（85%）通过使用RVS的二次超声检查被检测到。33个病变的MRI形态类型如下：肿块，16个；非肿块强化，5个；以及局灶性病变，12个。在RVS引导下的超声活检或切除活检显示，在这33个病变中，8个（24%）为恶性，其余25个（76%）为良性。总共53个（90%）MRI检测到的病变通过cB型和RVS在超声检查中得以识别（p < 0.001）。在使用RVS在乳房表面标记增强区域后，所有其余5个超声隐匿性病变均可在RVS下进行随访。尽管需要进一步的前瞻性研究，但我们的初步研究结果表明，使用RVS并结合额外的仰卧位MRI进行二次超声检查可能会提高cB型隐匿性MRI检测到的乳腺病变的超声和组织病理学检测率。
