Department of Radiology, Research Institute of Radiology, 65526Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea.
Acta Radiol. 2021 Jun;62(6):722-734. doi: 10.1177/0284185120941830. Epub 2020 Jul 19.
Despite the excellent contribution of contrast-enhanced breast magnetic resonance imaging (MRI), there are variable false-negative cases on MRI.
To evaluate the false-negative findings of breast cancer on previous MRI.
Between 2012 and 2016, we collected 132 patients who underwent surgery for a second primary cancer and had both current and previous MRI at an interval of <3 years. We included 45 patients; we excluded 38 patients who could not find a second cancer in the previous MRI and 49 patients who had a second cancer near to the original cancer and within within the same quadrant. Compared with current MRI, we retrospectively assessed the second primary cancer on previous MRI according to BI-RADS and analyzed the reasons of misinterpretation.
Analysis of previous MRI revealed 26 (57.8%) masses (mean size 7.7 ± 2.25 mm), 12 (26.7%) non-mass enhancements (mean size 14.7 ± 4.76 mm), and 7 (15.5%) foci. At first reading, 24 (53.3%) were missed, 17 (37.8%) were assessed as BI-RADS category 2 or 3, and 4 (8.9%) were assessed as category 4. On current MRI, 39 (86.7%) lesions showed an increase in size and 22 (48.9%) showed a change in kinetics to wash-out pattern.
On previous MRI, missed or misinterpreted cancers show variable findings of mass and non-mass enhancements with any types of kinetics. Careful application of BI-RADS is necessary as well as an appropriate biopsy. Any lesion that increases in size and changes in kinetics should not be underestimated.
尽管对比增强乳腺磁共振成像（MRI）贡献卓越，但 MRI 仍存在一些假阴性病例。
评估既往 MRI 中乳腺癌的假阴性结果。
在 2012 年至 2016 年间，我们收集了 132 例因第二原发癌而行手术且在 3 年内有当前和既往 MRI 的患者。我们纳入了 45 例患者；排除了 38 例在既往 MRI 中找不到第二原发癌的患者，以及 49 例第二原发癌位于原癌附近且位于同一象限内的患者。与当前 MRI 相比，我们回顾性地根据 BI-RADS 评估了既往 MRI 中的第二原发癌，并分析了误诊的原因。
对既往 MRI 的分析显示 26 例（57.8%）为肿块（平均大小 7.7±2.25mm），12 例（26.7%）为非肿块样强化（平均大小 14.7±4.76mm），7 例（15.5%）为局灶性病变。初次阅读时，24 例（53.3%）被漏诊，17 例（37.8%）评估为 BI-RADS 类别 2 或 3，4 例（8.9%）评估为类别 4。在当前 MRI 上，39 例（86.7%）病变显示大小增加，22 例（48.9%）显示动力学变化为洗脱模式。
既往 MRI 中漏诊或误诊的癌症表现为肿块和非肿块强化的各种表现，具有任何类型的动力学。有必要仔细应用 BI-RADS 并进行适当的活检。任何大小增加和动力学改变的病变都不应被低估。
