Evelyn H. Lauder Breast and Imaging Center, 300 E 66th St, New York, NY 10065.
Department of Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY.
AJR Am J Roentgenol. 2020 May;214(5):1175-1181. doi: 10.2214/AJR.18.19960. Epub 2020 Mar 11.
The objective of our study was to determine whether there are differences in outcome of screening MRI examinations in premenopausal women as a function of the week of the menstrual cycle in which the study was performed. The reports of consecutive screening MRI examinations performed from January 1, 2011, through December 31, 2012, of premenopausal women were reviewed. Only cases for which the 1st day of the last menstrual cycle was documented were included. Associations between the week of the menstrual cycle, degree of background parenchymal enhancement (BPE), final BI-RADS assessment, positive predictive values (PPVs), cancer detection rate (CDR), sensitivity, and specificity were noted. A total of 1536 MRI examinations of 1239 women were performed. Distribution of MRI examinations by menstrual cycle week was as follows: 21.8% ( = 335) in week 1, 35.4% ( = 544) in week 2, 23.4% ( = 360) in week 3, and 19.3% ( = 297) in week 4. In the overall comparison, there was no significant difference in BPE, BI-RADS assessment, PPV1, PPV2, PPV3, CDR, sensitivity, or specificity by the week of the menstrual cycle. When outcomes for cases with MRI performed in week 2 were compared with those of cases with MRI performed in weeks 1, 3, and 4 combined, there was no significant difference in the same outcome measures. There was no evidence of a difference in outcomes of screening MRI examinations as a function of the week of menstrual cycle in which the study is performed. The results of our study do not support the need for screening MRI to be performed in week 2 of the menstrual cycle.
我们的研究目的是确定在进行研究的月经周期周数的影响下,筛查性 MRI 检查的结果在绝经前妇女中是否存在差异。回顾了 2011 年 1 月 1 日至 2012 年 12 月 31 日连续进行的筛查性 MRI 检查的报告。仅包括记录了最后一次月经周期第 1 天的病例。注意了月经周期周数、背景实质增强(BPE)程度、最终 BI-RADS 评估、阳性预测值(PPV)、癌症检出率(CDR)、敏感性和特异性之间的关联。共对 1239 名女性的 1536 次 MRI 检查进行了分析。MRI 检查按月经周期周分布如下:第 1 周 21.8%(=335),第 2 周 35.4%(=544),第 3 周 23.4%(=360),第 4 周 19.3%(=297)。在总体比较中,BPE、BI-RADS 评估、PPV1、PPV2、PPV3、CDR、敏感性或特异性在月经周期周数方面无显著差异。当将第 2 周进行 MRI 的病例的结果与第 1、3 和 4 周合并进行 MRI 的病例的结果进行比较时,在相同的结果指标上没有差异。没有证据表明筛查性 MRI 检查的结果会因进行研究的月经周期周数而有所不同。我们的研究结果不支持在月经周期的第 2 周进行筛查性 MRI 的必要性。