Gity Masoumeh, Arabkheradmand Ali, Taheri Elham, Shakiba Madjid
Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran.
Department of Radiology, Medical Imaging Center, Tehran University of Medical Sciences, Tehran, Iran.
Arch Med Sci. 2018 Aug;14(5):1061-1069. doi: 10.5114/aoms.2016.62281. Epub 2016 Sep 12.
Breast magnetic resonance imaging (BMRI) has been identified as a valuable modality in the diagnosis of breast cancer and monitoring the response to chemotherapy. The aim of this study was to evaluate the relative importance of different descriptors of breast masses in contrast-enhanced breast MRI.
In a database of pathologically proven breast lesions, in total 433 masses in 312 patients detected by contrast-enhanced breast MRI were selected. All images were assessed according to the MRI BI-RADS lexicon and those with significant positive MRI findings (BI-RADS categories 3, 4, 5) were enrolled in the study.
Mean age of patients was 45.09 ±10.5 years. The most frequent BI-RADS score was 4 (60.7%), followed by 3 (27%). Among the morphologic descriptors of the enhancing masses, the findings most strongly associated with malignancy included spiculated margin (60.6%) and irregular shape (38%). Considering the dynamic descriptors, a wash-out pattern in the time-intensity curve was the most powerful finding associated with malignancy (27.9%). Among all breast MRI descriptors, the best odds ratio (OR) in association with malignancy was noted for speculated margin (OR = 10.2) followed by wash-out or plateau curves (OR = 6.1), size greater than 1 cm (OR = 4.3) and irregular shape (OR = 3.1).
It seems that morphologic descriptors of MRI BI-RADS for enhancing masses are quite specific, while dynamic descriptors of the masses are highly sensitive. Appropriate consideration and combination of different BI-RADS findings could help in better characterization of enhancing masses on breast MRI, lowering the rate of false positive reports and avoiding unnecessary biopsies.
乳腺磁共振成像（BMRI）已被确认为诊断乳腺癌及监测化疗反应的一种有价值的检查方法。本研究的目的是评估乳腺增强磁共振成像中乳腺肿块不同特征的相对重要性。
在一个经病理证实的乳腺病变数据库中，选取了312例患者经乳腺增强磁共振成像检测出的共433个肿块。所有图像均根据MRI BI-RADS词典进行评估，具有显著阳性MRI表现（BI-RADS分类3、4、5）的患者纳入本研究。
患者的平均年龄为45.09±10.5岁。最常见的BI-RADS评分是4（60.7%），其次是3（27%）。在增强肿块的形态学特征中，与恶性肿瘤最密切相关的表现包括毛刺状边缘（60.6%）和不规则形状（38%）。考虑动态特征，时间-强度曲线中的廓清型是与恶性肿瘤相关的最有力表现（27.9%）。在所有乳腺MRI特征中，与恶性肿瘤相关的最佳优势比（OR）见于毛刺状边缘（OR = 10.2），其次是廓清或平台型曲线（OR = 6.1）、大小大于1 cm（OR = 4.3）和不规则形状（OR = 3.1）。
似乎MRI BI-RADS中增强肿块的形态学特征相当具有特异性，而肿块的动态特征高度敏感。对不同BI-RADS表现进行适当考虑和综合，有助于更好地对乳腺MRI上的增强肿块进行特征描述，降低假阳性报告率并避免不必要的活检。
