在活检之前对乳房进行磁共振成像
David A Bluemke1, Constantine A Gatsonis, Mei Hsiu Chen
1Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Md, USA. dbluemke@jhmi.edu
JAMA
|December 9, 2004
概括
乳房MRI显示癌症检测的灵敏度很高,但特异性适度. 虽然它的积极预测价值超过了乳房检查,但组织采样仍然是确定诊断的必要条件.
科学领域:
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
- 医疗成像医学成像
背景情况:
- 乳腺磁共振成像 (MRI) 为癌症检测提供了高灵敏度.
- 它的使用越来越多地用于评估通过乳房影像识别的可疑乳腺病变.
研究的目的:
- 为了评估乳房MRI与乳房扫描相结合的准确性.
- 为了确定怀疑乳房图或临床发现的患者的诊断性能.
主要方法:
- 未来的多中心研究涉及14所大学医院的821名患者.
- 在活检之前进行了MRI检查,对MRI结果进行了盲目的解释.
- 关键的结果指标包括接收器运行特征曲线 (AUC) 下的面积,灵敏度和特异性.
主要成果:
- 乳腺MRI的AUC总值为0.88,灵敏度为88.1%,特异性为67.7%.
- 在不同的乳腺密度,瘤组织学和更年期状态中,表现一致.
- 磁力共振成像的积极预测值 (72.4%) 显著高于乳房造影 (52.8%).
结论:
- 乳房MRI显示高灵敏度,但只有中度的特异性,无论患者或瘤的特征.
- 尽管MRI与乳房镜相比具有更高的积极预测值,但MRI并不能消除对活检的需求.
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