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临床应用中简化和超快的乳腺 MRI

Abbreviated and Ultrafast Breast MRI in Clinical Practice.

机构信息

From the Department of Radiology, New York University School of Medicine, 160 E 34th St, New York, NY 10016.

出版信息

Radiographics. 2020 Oct;40(6):1507-1527. doi: 10.1148/rg.2020200006. Epub 2020 Sep 18.

Abstract

Abbreviated and ultrafast breast MRI are emerging techniques that are now entering clinical practice and reflect an increasing understanding of breast cancer heterogeneity. These techniques may represent potential answers to shortcomings of mammographic screening, providing an opportunity to curb interval cancers, maximize diagnostic accuracy, and minimize overdiagnosis. Targeting more aggressive tumor subtypes may play a role in evidence-based de-escalation of breast cancer management, and abbreviated techniques have proved promising in early noninferiority studies. Functional characterization of tumors at MRI also has the potential for noninvasive tumor subtyping based on radiomics and radiogenomics and may ultimately streamline increasingly individualized breast cancer care. The purpose of this article is to describe techniques of abbreviated and ultrafast breast MRI, recognize their pros and cons, and discuss clinical applications and implications. The goals are to define terminology, consider diagnostic parameters, and emphasize key concepts. As these novel techniques enter clinical care and continue to evolve, it is essential that the radiologist understands the rationale and limitations behind these approaches and how and why interpretation may differ from that of conventional MRI. RSNA, 2020.

摘要

缩写和超快乳腺 MRI 是新兴技术,现已进入临床实践,反映出人们对乳腺癌异质性认识的不断提高。这些技术可能是对乳腺 X 线筛查缺陷的潜在解决方案,为抑制间期癌、提高诊断准确性和减少过度诊断提供了机会。针对侵袭性更强的肿瘤亚型可能在基于循证的乳腺癌管理降级中发挥作用,而且缩写技术在早期非劣效性研究中已显示出前景。MRI 对肿瘤的功能特征分析也有可能基于放射组学和放射基因组学进行无创性肿瘤分型,最终可能简化日益个体化的乳腺癌护理。本文旨在描述缩写和超快乳腺 MRI 技术,认识其优缺点,并讨论其临床应用和意义。目的是定义术语、考虑诊断参数,并强调关键概念。随着这些新的技术进入临床护理并不断发展,放射科医生了解这些方法背后的原理和局限性以及解释如何和为何可能与常规 MRI 不同非常重要。RSNA,2020 年。

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