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首页> 外文期刊>Acta Radiologica >Invasive lobular carcinoma of the breast: MRInvasive MRI pathological correlation following bilateral total mastectomy
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Invasive lobular carcinoma of the breast: MRInvasive MRI pathological correlation following bilateral total mastectomy

机译：乳腺浸润性小叶癌：MRI双侧全乳切除后的MRI MRI病理相关性

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Background: Invasive lobular carcinoma (ILC) is more often multifocal and bilateral than invasive ductal carcinoma. MRI is usually recommended for detection of all ILC sites. The performance of known diagnostic breast MRI criteria for ILC characterization has not been evaluated to date using bilateral mastectomy specimens as gold standard. Purpose: To determine the value of BI-RADS 2006 MRI criteria for ILC detection and characterization, using pathological examination of bilateral mastectomy specimens as the reference standard. Material and Methods: Between 2004 and 2007, we retrospectively included all patients with pathologically documented ILC referred to our institution for bilateral mastectomy and preoperative bilateral breast MRI. The location, diameter, and characteristics (BI-RADS) of all lesions were compared with pathological findings. The sensitivity and positive predictive value of bilateral breast MRI for the diagnosis of ILC were calculated. Association of MRI BI-RADS categorical variables and characterization of ILC were assessed (Fisher exact test). Results: Among 360 patients treated for ILC in 2004-2007, 15 patients qualified for this study. Thirty-one ILC foci were found on pathological examination (30 ipsilateral and 1 contralateral tumor; mean diameter 23 mm; range 2-60 mm) and all were identified on MRI, with 90% of masses and 10% non-mass-like enhancements; MRI features significantly associated with ILC included absence of smooth margins (P = 0.02) and rimshaped enhancement (P = 0.039). Enhancement kinetics of the 31 foci were evenly distributed among washout, plateau, and persistent profiles. Eleven additional lesions were seen on MRI, mainly corresponding to fibrocystic disease; 91% presented as masses and 9% had a wash-out profile. Conclusion: Based on the 2006 BI-RADS criteria, breast MRI shows a high sensitivity for ILC detection, at the expense of a 26% false-positive rate, suggesting that a pathological proof by US-or MR-guided biopsy is required in case of suspicious MRI images in this context.
机译：背景：浸润性小叶癌（ILC）比浸润性导管癌更常见于多灶性和双侧。通常建议使用MRI来检测所有ILC部位。迄今为止，尚未使用双侧乳房切除术标本作为金标准评估用于ILC表征的已知乳腺MRI诊断标准的性能。目的：使用双侧乳房切除术标本的病理检查作为参考标准，确定BI-RADS 2006 MRI标准对ILC检测和表征的价值。材料和方法：2004年至2007年，我们回顾性分析了所有经病理学证实为ILC的患者，这些患者被转介到我们机构进行双侧乳房切除术和术前双侧乳房MRI检查。将所有病变的位置，直径和特征（BI-RADS）与病理结果进行比较。计算了双侧乳腺MRI对ILC诊断的敏感性和阳性预测价值。评估了MRI BI-RADS分类变量与ILC表征的关联（Fisher精确检验）。结果：在2004-2007年间接受ILC治疗的360例患者中，有15例符合这项研究的条件。在病理检查中发现了31个ILC病灶（30个同侧和1个对侧肿瘤;平均直径23 mm;范围2-60 mm），并在MRI上均被发现，占90％的肿块和10％的非肿块样增强;与ILC显着相关的MRI特征包括无光滑边缘（P = 0.02）和边缘增强（P = 0.039）。 31个病灶的增强动力学在洗脱，平稳和持续分布之间均匀分布。 MRI上又见到11个病变，主要与纤维囊性疾病相对应。 91％呈肿块状，9％呈冲刷状。结论：根据2006 BI-RADS标准，乳腺MRI对ILC检测具有很高的敏感性，但假阳性率却高达26％，这表明在这种情况下，需要通过US或MR引导的活检进行病理学证明在这种情况下的可疑MRI图像。

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