Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Largo Agostino Gemelli 8, 00168 Rome, Italy.
Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Largo Agostino Gemelli 8, 00168 Rome, Italy.
Diagn Interv Imaging. 2018 Dec;99(12):815-826. doi: 10.1016/j.diii.2018.08.011. Epub 2018 Sep 22.
Background parenchymal enhancement (BPE) on breast magnetic resonance imaging (MRI) is a dynamic process, which varies among women and within the same woman over time due to different factors. BPE has profound implications for women with or at risk of breast cancer. Breast radiologist should be aware of factors that could potentially influence BPE and have to be familiar with its typical appearance. Marked BPE could indeed affect the diagnostic accuracy of breast MRI, but this shortcoming can be minimized through evaluation by dedicated radiologists, in order to correctly interpret and properly manage the additional findings. BPE shows promise as an imaging biomarker but many issues need to be addressed before it can be used either to determine screening strategy or the value of risk-reducing interventions. This review analyzes the clinical influence of BPE on breast MRI interpretation, breast cancer staging and surgical outcome and discusses current available evidences about BPE as an imaging biomarker.
背景实质增强（BPE）是乳腺磁共振成像（MRI）中的一个动态过程，由于不同因素的影响，它在女性之间和同一女性的不同时间存在差异。BPE 对患有或有乳腺癌风险的女性具有深远的影响。乳腺放射科医生应该了解可能影响 BPE 的因素，并熟悉其典型表现。明显的 BPE 确实会影响乳腺 MRI 的诊断准确性，但通过专门的放射科医生进行评估，可以最小化这一缺陷，以便正确解释和妥善处理额外的发现。BPE 有望成为一种影像学生物标志物，但在确定筛查策略或降低风险干预措施的价值之前，仍有许多问题需要解决。本文综述分析了 BPE 对乳腺 MRI 解读、乳腺癌分期和手术结果的临床影响，并讨论了目前关于 BPE 作为影像学生物标志物的可用证据。
