Zhu Chun-Rong, Chen Ke-Yu, Li Pan, Xia Zhi-Yang, Wang Bin
North Sichuan Medical College, Nanchong, Sichuan, PR China.
Department of Breast and Thyroid Surgery, The Third People's Hospital of Chengdu, Chengdu, Sichuan, PR China.
Acta Radiol. 2021 Oct;62(10):1290-1297. doi: 10.1177/0284185120963900. Epub 2020 Oct 15.
The sensitivity of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for detecting breast cancer was high and the specificity was relatively low. However, diffusion-weighted imaging (DWI) has a high specificity in the diagnosis of malignant lesions.
To evaluate the accuracy of the multiparametric MRI (mp-MRI) in distinguishing the breast malignant lesions from the benign lesions.
A comprehensive search of the PubMed, Embase, and Cochrane Library electronic databases was conducted up to March 2020. Data were analyzed for the following indexes: pooled sensitivity and specificity; positive likelihood ratio; negative likelihood ratio; diagnostic odds ratio; and the area under the curve.
A total of 2356 patients with 1604 malignant and 967 benign breast lesions were included from 22 studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve for mp-MRI were 0.93, 0.85, 6.3, 0.08, 81, and 0.96, respectively. The pooled sensitivity, specificity, and area under the curve for DCE-MRI alone were 0.95, 0.71, and 0.92, respectively. The pooled sensitivity, specificity, and area under the curve for DWI alone were 0.88, 0.84, and 0.93, respectively.
The mp-MRI did not improve the sensitivity but increased the specificity for the diagnosis of breast malignant lesions.
动态对比增强磁共振成像(DCE-MRI)检测乳腺癌的敏感性较高,但特异性相对较低。然而,扩散加权成像(DWI)在恶性病变诊断中具有较高的特异性。
评估多参数磁共振成像(mp-MRI)区分乳腺恶性病变与良性病变的准确性。
截至2020年3月,对PubMed、Embase和Cochrane图书馆电子数据库进行全面检索。分析以下指标的数据:合并敏感性和特异性;阳性似然比;阴性似然比;诊断比值比;以及曲线下面积。
22项研究共纳入2356例患者,其中有1604例乳腺恶性病变和967例良性病变。mp-MRI的合并敏感性、特异性、阳性似然比、阴性似然比、诊断比值比和曲线下面积分别为0.93、0.85、6.3、0.08、81和0.96。单纯DCE-MRI的合并敏感性、特异性和曲线下面积分别为0.95、0.71和0.92。单纯DWI的合并敏感性、特异性和曲线下面积分别为0.88、0.84和0.93。
mp-MRI并未提高乳腺恶性病变诊断的敏感性,但提高了特异性。