From the Department of Diagnostic Radiology (Nagadi), King Abdulaziz University Hospital, from the Department of Radiologic Sciences (Nagadi, Elsayed), Faculty of Applied Medical Science, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia,and from the Department of Diagnostic Radiology (Elsayed), Faculty of Medicine, Cairo University, Cairo, Egypt.
Saudi Med J. 2024 Aug;45(8):799-807. doi: 10.15537/smj.2024.45.8.20230748.
To investigate whether magnetic resonance imaging (MRI) best detects early malignancy in high-risk women.
A retrospective, cross-sectional study, carried out at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, included 419 female breast cancer patients aged 16-84 years (mean age of 49). Data were collected from the radiological department's database to compare the MRI, ultrasound (US), and mammography results, with or without tissue biopsy.
In diagnosing benign versus malignant lesions, MRI showed significant agreement with tissue biopsy, with high sensitivity (70%) and specificity (87%); its positive predictive value (PPV) was 92% and negative predictive value (NPV) was 56%. While US has a PPV of 84% and NPV of 63%; with a sensitivity (79%) and specificity (71%). In patients without tissue biopsy, there was little difference between mammography and US compared with MRI results.
Magnetic resonance imaging is more effective than US and mammography for early detection of BC. It showed high sensitivity in detecting breast lesions and high specificity in characterizing their nature when correlated with pathological results. Ultrasound screening followed by MRI is suggested for undetected or suspected lesions. This will increase the breast lesion detection rate, reduce unneeded tissue biopsies, and enhance the disease's survival rate.
探究磁共振成像（MRI）是否能更好地检测高危女性的早期恶性肿瘤。
这是在沙特阿拉伯吉达的阿卜杜勒阿齐兹国王大学医院进行的一项回顾性、横断面研究，共纳入 419 名年龄在 16-84 岁（平均年龄 49 岁）的女性乳腺癌患者。研究从放射科的数据库中收集数据，以比较 MRI、超声（US）和乳房 X 线摄影的结果，有无组织活检均可。
在诊断良性与恶性病变方面，MRI 与组织活检具有显著一致性，具有较高的灵敏度（70%）和特异性（87%）；其阳性预测值（PPV）为 92%，阴性预测值（NPV）为 56%。而 US 的 PPV 为 84%，NPV 为 63%；灵敏度（79%）和特异性（71%）。在未进行组织活检的患者中，与 MRI 结果相比，乳房 X 线摄影和 US 的差异较小。
与 US 和乳房 X 线摄影相比，MRI 更有助于早期发现乳腺癌。它在检测乳房病变方面具有较高的灵敏度，在与病理结果相关联时对其性质的特异性也较高。建议对未检出或可疑的病变进行超声筛查后行 MRI，这将提高乳房病变的检出率，减少不必要的组织活检，并提高疾病的生存率。
