激素替代疗法治疗女性的乳房磁共振成像筛查。
Screening breast magnetic resonance imaging in women with hormone replacement therapy.
机构信息
Department of Breast Surgery, Hangzhou Women's Hospital, Hangzhou, 310008, China.
Department of Reproductive Endocrinology, Hangzhou Women's Hospital, Kunpeng Road 369, Hangzhou, 310008, China.
出版信息
Eur J Med Res. 2018 Oct 20;23(1):48. doi: 10.1186/s40001-018-0351-8.
OBJECTIVE
The objective of this study was to compare the performance of screening mammography versus magnetic resonance imaging (MRI) in hormone replacement therapy (HRT) users.
METHODS
We performed a retrospective review of 4628 women who had mammography or breast MRI screening from the beginning of HRT use at three institutions from April 2005 to December 2015. Information of demographics, number of biopsies performed and pathologic outcomes were collected. Sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of screening mammography and MRI were compared.
RESULTS
Totally 11,540 screening studies were collected, including 9580 mammography studies and 1960 MRI studies. Breast cancer was diagnosed in 26 patients. Of the 26 cancers, MRI detected 24 and mammography detected 15. For mammography, the sensitivity, specificity, PPV, and NPV were 57.7%, 99.1%, 14.6%, and 99.9%, respectively; for MRI, those values were 92%, 92.5%, 14.2%, and 99.9%, respectively. MRI screening was much more sensitive than mammography screening (p < 0.05, 92% vs 57.7%). There was no difference of specificity, PPV and NPV between two modalities.
CONCLUSIONS
Our data showed that screening breast MRI may be a useful adjunct modality of mammography in HRT users.
目的
本研究旨在比较激素替代疗法（HRT）使用者中筛查性乳房 X 光摄影与磁共振成像（MRI）的性能。
方法
我们对 2005 年 4 月至 2015 年 12 月在三个机构开始 HRT 使用时进行乳房 X 光摄影或乳房 MRI 筛查的 4628 名女性进行了回顾性研究。收集了人口统计学信息、活检次数和病理结果。比较了筛查性乳房 X 光摄影和 MRI 的敏感性、特异性、阴性预测值（NPV）和阳性预测值（PPV）。
结果
共收集了 11540 项筛查研究，包括 9580 项乳房 X 光摄影研究和 1960 项 MRI 研究。诊断出 26 例乳腺癌。26 例癌症中，MRI 检测出 24 例，乳房 X 光摄影检测出 15 例。对于乳房 X 光摄影，敏感性、特异性、PPV 和 NPV 分别为 57.7%、99.1%、14.6%和 99.9%；对于 MRI，这些值分别为 92%、92.5%、14.2%和 99.9%。MRI 筛查比乳房 X 光摄影筛查更敏感（p<0.05，92%对 57.7%）。两种方法的特异性、PPV 和 NPV 没有差异。
结论
我们的数据表明，筛查性乳房 MRI 可能是 HRT 使用者乳房 X 光摄影的有用辅助手段。
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