术前乳腺MRI用于新诊断乳腺癌后的疾病范围评估:一个回顾性队列研究
Chi Trinh1, Victoria Shi1, Tiffany Pham1
1The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medicine, Baltimore, Maryland.
Journal of the American College of Radiology : JACR
|October 11, 2025
概括
手术前的乳房MRI通过检测额外的病变和减少重新切割率来改善手术规划. 然而,它的使用因患者年龄,种族和瘤特征而有很大差异,这表明潜在的获取差异.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 手术前的乳房MRI为乳腺癌的手术规划提供了好处.
- 之前的研究表明,在手术前使用乳腺MRI时存在差异.
- 公平地获得像MRI这样的先进成像工具是一个日益关注的问题.
研究的目的:
- 根据患者的社会人口统计学和临床因素,评估手术前乳腺MRI使用的变化.
- 在这些变化的背景下,评估手术前MRI的好处.
主要方法:
- 对1792名接受手术的乳腺癌新诊断患者进行了回顾性队列研究.
- 对那些接受 (n=992) 和未接受 (n=800) 手术前核磁共振成像的患者的特征进行比较.
- 使用奇二测试进行统计分析,以比较组.
主要成果:
- 在年轻患者 (≤70岁),白人和其他种族以及乳房密度较高或瘤阶段较高的患者中,MRI的使用率更高.
- 利用因受体状态 (在Her2+疾病中最高) 和组织学 (侵入性叶状癌) 而有所不同.
- 手术前的MRI在51.5%的病例中发现了额外的病变,导致图像引导的活检与显著的恶性病变/高风险发现. 接受MRI治疗的患者的乳房切除率较高,但重新切除率较低 (8%vs14%).
结论:
- 术前MRI通过检测额外的病变和减少重新手术的需要,提高了手术规划.
- 基于年龄,种族,乳腺密度和瘤特征,MRI利用率存在显著差异.
- 有针对性的干预措施是必要的,以确保公平获得手术前乳腺MRI,并为临床指导方针提供信息.
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