MRI引导下乳腺定位活检术应用效能探讨  

Can the Number of Unnecessary MRI-guided Localization be Reduced by Means of Breast MRI Characters?

作　　者：王明瑶[1] 所世腾[1] 华佳[1] 张丹丹 华小兰[1] 李岚[1] 张庆[1] 

机构地区：[1]上海交通大学医学院附属仁济医院放射科

出　　处：《中国医学计算机成像杂志》2018年第1期25-31,共7页Chinese Computed Medical Imaging

基　　金：上海交通大学医工交叉基金重点项目No.YG2014ZD05~~

摘　　要：目的:细化分析仅在MRI下显示的乳腺病灶的影像学特征以减少不必要的MRI引导下定位活检。方法:75例(共75个病灶)经MRI穿刺定位活检病理证实乳腺病患者,女性,平均年龄44.4±11.0岁,其中13例为恶性病变,62例为良性病变,所有病例穿刺术前均行常规3.0T MRI检查、且BI-RADS分级达4级。根据Fischer评分标准对穿刺术前病灶MRI影像特征进行回顾性分析,将病灶评分与病理结果进行对照,并运用受试者操作特征曲线(ROC)评价其诊断的准确度。结果:Fischer评分标准的曲线下面积(AUC)为0.802(95%CI:0.694~0.885),表现出较高诊断效能。ROC分析当取cut-off值为≤3时,可在不遗漏恶性病灶的情况下减少21例(33.8%)不必要的活检。结论:对于仅在MRI上显示的可疑病灶,运用Fischer评分标准进行进一步评估,能在一定程度上减少不必要的MRI引导下定位活检术。Purpose： To assess whether unnecessary MRI guided wire localizations for MR/-only breast lesions can be obviated through the evaluation of their magnetic resonance imaging （MRI） characters. Methods： This retrospective study evaluated 75 female patients with 75 suspicious （BI-RADS 4） breast lesions, which were only visible on MR/and were referred to our institution for MRI-guided wire localization. All patients （mean age 44.4±11.0 years） were with 75 histopathologically verified lesions, of which 13 （17.3%） were proved to be malignant. All the patients were undergone 3.0T breast MRI exam, and each lesion was localized on a 0.4T MRI. All the lesions were evaluated according to the Fischer＇s score for breast MR/by an experienced reader. According to the histopathological results of these lesions, receiver operating characteristic （ROC） curve analysis was used to evaluate the diagnostic accuracy. Results： The area under the curve （AUC） was 0.802 （95% CI： 0.694-0.885）, which indicated a favorable and valid diagnostic performance. ROC analysis revealed that if the cut-off was set as ≤3, unnecessary wire localization could be avoided potentially in 21 cases （33.8%）, and without any false-negative cases. Conclusions： By evaluating the imaging characters of MRI- only breast lesions with the Fischer＇s score, unnecessary wire localizations could be avoided.

关 键 词：磁共振 乳腺癌 影像学引导下活检 评分系统 

分 类 号：R445.2[医药卫生—影像医学与核医学]