Acibadem M.A.A. University Medical School, 32, Kayisdagi Cad. Atasehir, Istanbul, Turkey.
Maltepe Üniversitesi Kampüsü Meslek yüksek okulu, Başıbüyük Maltepe, Istanbul, Turkey.
Clin Imaging. 2021 Jul;75:22-26. doi: 10.1016/j.clinimag.2020.12.011. Epub 2020 Dec 26.
The aim of this study is to evaluate the effect of iron oxide particle deposition on follow-up mammograms and MRI examinations of patients who underwent sentinel lymph node detection with iron oxide particles.
Two hundred and eighteen patients who had sentinel lymph node biopsy (SLNB) with iron oxide particles were evaluated. Follow-up MRI and mammography were available in 36 and 69 cases respectively. MRI examinations were evaluated for ferromagnetic artifacts that were graded as follows: 0 = No artifact, 1 = Focal area, 2 = Segmental and 3 = Regional signal void artifact. Mammography artifacts were evaluated for the presence of dense particles. Pearson's chi-square test was used for statistical analyses and P < 0.05 was accepted as significant.
MRI artifact grading was as follows: Grade 0: 11 (30.6%), Grade 1: 14 (38.9%), Grade 2: 3 (8.3%), and Grade 3: 8 (22.2%). The grade of artifacts differed across surgery types (P = 0.019). Grade 3 artifacts were higher in breast conserving cases whereas Grade 0 was more frequent in subcutaneous mastectomy cases. Three out of 69 (4.4%) cases who had follow-up mammography had artifacts due to iron oxide particle accumulation which presented as Grade 3 MRI artifact in all.
Accumulation of iron oxide particles after SLNB with paramagnetic tracers causes artifacts on follow-up MRI examinations in half of the cases but it is significantly low in mammograms. These artifacts may be confusing in the evaluation of the images. Radiologists must be aware of these tracers and their artifacts whereas patients should be questioned for the type of SLNB before a follow-up examination.
本研究旨在评估铁氧化物颗粒沉积对接受铁氧化物颗粒示踪前哨淋巴结检测的患者后续乳腺 X 线摄影和 MRI 检查的影响。
对 218 例接受铁氧化物颗粒示踪前哨淋巴结活检（SLNB）的患者进行评估。分别有 36 例和 69 例患者可获得后续 MRI 和乳腺 X 线摄影检查。MRI 检查评估铁磁性伪影，分级如下：0=无伪影，1=局灶性区域，2=节段性，3=区域性信号缺失伪影。乳腺 X 线摄影评估致密颗粒伪影的存在。采用 Pearson χ2 检验进行统计学分析，P<0.05 为差异有统计学意义。
MRI 伪影分级如下：0 级：11 例（30.6%），1 级：14 例（38.9%），2 级：3 例（8.3%），3 级：8 例（22.2%）。手术类型不同，伪影分级也不同（P=0.019）。保乳手术中 3 级伪影较高，而皮下乳房切除术 0 级更常见。69 例（4.4%）行后续乳腺 X 线摄影的患者中，有 3 例由于铁氧化物颗粒堆积导致出现伪影，所有患者的 MRI 伪影均为 3 级。
SLNB 后顺磁性示踪剂引起的铁氧化物颗粒堆积导致半数患者的后续 MRI 检查出现伪影，但在乳腺 X 线摄影中明显较低。这些伪影可能会在图像评估中造成混淆。放射科医生必须了解这些示踪剂及其伪影，而患者在进行随访检查前应询问 SLNB 的类型。
