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基线高风险筛查乳腺 MRI 的短间隔随访的效用。

The Utility of Short-Interval Follow-Up for Baseline High-Risk Screening Breast MRI.

机构信息

Department of Radiology, McMaster University, Hamilton, Ontario, Canada.

Department of Radiology, University of Ottawa, Ottawa, Ontario, Canada.

出版信息

Can Assoc Radiol J. 2020 May;71(2):226-230. doi: 10.1177/0846537119895752. Epub 2020 Feb 5.

Abstract

OBJECTIVE

Patients with a high lifetime risk of developing breast cancer undergo annual screening magnetic resonance imaging (MRI) starting at age 30. A proportion of these patients are subsequently required to undergo short-interval follow-up MRI 6 months after their baseline examination. The purpose of this study was to evaluate the utility and outcome of these short-interval follow-up examinations in this population.

METHODS

A retrospective review was performed of 523 patients who received their baseline high-risk breast screening MRI at our institution between 2013 and 2017. The proportion of patients who received a short-interval follow-up MRI at 6 months was recorded. The findings at baseline and follow-up MRI were recorded, as well as the outcomes and results of any interventions performed.

RESULTS

Ninety-six (17.6%) patients (age range: 25-67, mean age: 41) received a short-interval follow-up MRI following their baseline screening examination. Indications for follow-up included moderate to marked background parenchymal enhancement, nonmass enhancement, and likely benign enhancing mass. Of the 92 patients, 5 (5.4%) went on to have a biopsy, with none revealing a malignant pathology. The remainder either returned to routine screening (91.3%) or received further imaging in the form of ultrasound or additional follow-up MRI (3.3%).

CONCLUSION

Short-interval follow-up breast MRI in high-risk patients after a baseline screening study with likely benign findings is unlikely to yield clinically significant findings. This retrospective study can be considered a starting point for additional future work looking at the rate, indications, and yield of short-interval follow-up following baseline high-risk screening breast MRI studies.

摘要

目的

具有高终生乳腺癌发病风险的患者从 30 岁开始每年进行筛查性磁共振成像(MRI)。其中一部分患者随后需要在基线检查后 6 个月进行短间隔随访 MRI。本研究的目的是评估该人群中这些短间隔随访检查的效用和结果。

方法

回顾性分析了 2013 年至 2017 年期间在我院接受基线高风险乳腺癌筛查 MRI 的 523 例患者。记录了接受 6 个月短间隔随访 MRI 的患者比例。记录了基线和随访 MRI 的发现,以及任何干预措施的结果和结果。

结果

96 例(17.6%)患者(年龄范围:25-67 岁,平均年龄:41 岁)在基线筛查检查后接受了短间隔随访 MRI。随访的指征包括中度至明显背景实质增强、非肿块增强和可能良性强化肿块。在 92 例患者中,有 5 例(5.4%)进行了活检,均未发现恶性病理。其余患者要么回到常规筛查(91.3%),要么接受了超声或其他随访 MRI 等进一步影像学检查(3.3%)。

结论

在基线筛查研究中发现可能良性的情况下,对高风险患者进行短间隔随访乳腺 MRI 不太可能产生有临床意义的发现。这项回顾性研究可以作为进一步研究的起点,探讨基线高风险筛查性乳腺 MRI 研究后短间隔随访的频率、指征和效果。

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