在哺乳期进行乳房MRI进行高风险查
Noam Nissan1, Jill Gluskin1, Rosa Elena Ochoa-Albiztegui1
1Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
哺乳期的乳房MRI查显示,由于突出的背景辅酶增强 (BPE),其有效性有限,导致BI-RADS 3得分更多. 尽管特异性较低,但它仍然适用于高风险个体.
科学领域:
- 放射学和医学成像学 医学成像学
- 在瘤学瘤学.
- 妇女健康 妇女健康
背景情况:
- 乳腺MRI对于高风险乳腺癌查至关重要.
- 哺乳期显著改变乳腺膜,可能会影响MRI解释.
- 乳房核磁共振 (MRI) 在哺乳期的先前研究集中在诊断,而不是查,设置.
研究的目的:
- 评估乳腺MRI的诊断性能,以对哺乳期患者进行高风险查.
- 为了比较哺乳期和非哺乳期患者的背景辅酶增强 (BPE) 和BI-RADS得分.
主要方法:
- 从2008年4月到2024年3月对查乳腺MRI进行回顾.
- 在哺乳期患者和对照人群之间比较BPE等级和BI-RADS得分流行率.
- 诊断性能指标是使用活检或1年随访作为参考计算的.
主要成果:
- 在82%的哺乳期患者中观察到标记的BPE,高于最近没有哺乳期的患者 (p < 0.001).
- 与对照组相比,哺乳期患者的BI-RADS 3评分率较高 (28%对比7%,p < 0.001),BI-RADS 1/2评分率较低 (62%对比84.6%,p = 0.002).
- 敏感度为50%,特异性为60%,PPV为2.0%,NPV为98.6%,用于哺乳期MRI查.
结论:
- 哺乳期显著的BPE限制了乳房MRI高风险查的有效性,增加了BI-RADS 3分类并降低了特异性.
- 尽管存在局限性,但乳房核磁共振扫描在哺乳期对高危人群具有临床意义,例如BRCA携带者,因为怀孕相关的乳腺癌的风险.
- 放射科医生需要熟悉哺乳期乳房MRI的特定外观,以确保适当的解释.
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