Chayakulkheeree Jatuporn, Pungrassami Dirapit, Prueksadee Jenjeera
Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Chulalongkorn University, Thailand.
Pol J Radiol. 2019 Oct 18;84:e413-e418. doi: 10.5114/pjr.2019.89690. eCollection 2019.
To determine the diagnostic value of breast magnetic resonance imaging (MRI) in detecting axillary metastatic node in newly diagnosed breast cancer, we assessed the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of breast MRI.
Data were collected retrospectively from January 2011 to December 2018. Preoperative breast MRI of women with newly diagnosed breast cancer were reviewed to evaluate the axillary nodal staging by using the morphological characteristic of metastatic axillary lymph node. Statistical analysis was performed to assess the performance of breast MRI in diagnosing metastatic axillary lymph nodes based on the pathological result.
A total of 131 women with breast cancer were analysed. Two hundred and twenty-seven axillary lymph nodes from preoperative breast MRIs were considered to be metastasis. 65.65% (86 patients) of the breast MRI results matched with the pathological results: 37 patients with N0 stage, 39 patients with N1 stage, eight patients with N2 stage, and two patients with N3 stage. Sensitivity of breast MRI for axillary nodal staging was 98.5% (95% CI: 92-100%), and the negative predictive value was 96.4% (86.2-99.9%). Specificity of breast MRI for axillary nodal staging was 57.8% (44.8-70.1%) and the positive predictive value was 71% (60.6-79.9%).
Our study showed that the breast MRI had a high sensitivity (98.5%) and high NPV (96.4%) in detecting metastatic axillary lymph nodes, but its specificity was only fair (57.8%). Overestimation and underestimation of the MRI in N staging were also found in 20.61% and 12.98% of cases, respectively.
为了确定乳腺磁共振成像（MRI）在检测新诊断乳腺癌腋窝转移淋巴结方面的诊断价值，我们评估了乳腺MRI的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。
回顾性收集2011年1月至2018年12月的数据。对新诊断乳腺癌女性的术前乳腺MRI进行回顾，通过转移性腋窝淋巴结的形态特征评估腋窝淋巴结分期。基于病理结果进行统计分析，以评估乳腺MRI在诊断转移性腋窝淋巴结方面的表现。
共分析了131例乳腺癌女性。术前乳腺MRI检查出的227个腋窝淋巴结被认为有转移。65.65%（86例患者）的乳腺MRI结果与病理结果相符：37例N0期患者，39例N1期患者，8例N2期患者，2例N3期患者。乳腺MRI对腋窝淋巴结分期的敏感性为98.5%（95%CI：92 - 100%），阴性预测值为96.4%（86.2 - 99.9%）。乳腺MRI对腋窝淋巴结分期的特异性为57.8%（44.8 - 70.1%），阳性预测值为71%（60.6 - 79.9%）。
我们的研究表明，乳腺MRI在检测转移性腋窝淋巴结方面具有高敏感性（98.5%）和高阴性预测值（96.4%），但其特异性仅为一般水平（57.8%）。在20.61%和12.98%的病例中，还分别发现MRI在N分期中存在高估和低估的情况。
