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首页> 外文期刊>Acta Radiologica >Breast MRI as an adjunct to mammography: Does it really suffer from low specificity? A retrospective analysis stratified by mammographic BI-RADS classes.
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Breast MRI as an adjunct to mammography: Does it really suffer from low specificity? A retrospective analysis stratified by mammographic BI-RADS classes.

机译：乳腺MRI作为乳腺X线摄影的辅助手段：它真的遭受特异性低的困扰吗？回顾性分析按乳房X线摄影BI-RADS类别进行分层。

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BACKGROUND: Reports on the specificity of breast MRI are heterogeneous, depending on the respective setting of the performed study. PURPOSE: To retrospectively estimate the sensitivity and especially the specificity of breast MRI in the non-screening setting as an adjunct to mammography sorted by breast density and to estimate the accuracy of breast MRI in cases rated BI-RADS 0 and 3 mammographically. MATERIAL AND METHODS: A total of 216 consecutive patients with referral to breast MRI and previously acquired mammography were enrolled in this analysis. Negative findings were followed up with a mean time of 26.7 months. The loss to follow-up was 10.8%. The single breast was regarded as the study subject (n=399, 364 cases were eligible for calculation of diagnostic accuracy). BI-RADS 1 and 2 were rated as benign, 4 and 5 as malignant. BI-RADS 0 and 3 were analyzed separately. The 95% confidence intervals (CIs) were calculated from the normally approximated binomial distribution and taken to represent significant differences for the two imaging modalities if they did not overlap. RESULTS: Among the study population, 62 malignant neoplasms were detected. For cases rated BI-RADS 1, 2, 4, and 5 (n=251), the sensitivity of breast MRI was 95.7% (95% CI 89.9-100.0%) and 74.5% (95% CI 62.0-87.0%) for mammography, respectively. The specificity of breast MRI was 96.1% (95% CI 93.4-98.8%) and 92.2% (95% CI 88.5-95.9%) for mammography, respectively. The diagnostic accuracy of breast MRI did not depend on breast density. In cases rated BI-RADS 0, n=57 (3, n=56), breast MRI achieved a sensitivity of 100% (90.9%) and a specificity of 98.1% (88.9%). There was a significant (P< 0.01) accumulation of dense breast tissue (ACR IV) in breasts rated BI-RADS 0 in mammography. Breast MRI missed three malignant lesions, two of them being smaller than 3 mm. CONCLUSION: There is no rationale to criticize the low specificity of breast MRI when used as an adjunct to mammography. The independency of the diagnostic accuracy of breast MRI from breast density makes it a worthwhile choice in mammographic BI-RADS 0 cases.
机译：背景：关于乳房MRI特异性的报告不尽相同，具体取决于所进行研究的背景。目的：回顾性评估在非筛查场所作为乳房X线检查的辅助手段（按乳房密度排序）的乳房MRI的敏感性，尤其是其特异性，并评估在乳房X线检查级别为BI-RADS 0和3的病例中乳房MRI的准确性。材料与方法：本研究共纳入216例连续接受乳腺MRI检查和先前获得的乳房X线照相的患者。随访阴性结果，平均时间26.7个月。随访损失为10.8％。单只乳房被视为研究对象（n = 399，符合条件的364例可用于诊断准确性的计算）。 BI-RADS 1和2被评为良性，4和5被评为恶性。 BI-RADS 0和3分别进行了分析。从正常近似的二项式分布计算出95％的置信区间（CIs），如果两个成像模态不重叠，则代表两个成像模态的显着差异。结果：在研究人群中，检出了62例恶性肿瘤。对于分级为BI-RADS 1、2、4和5（n = 251）的病例，其MRI的敏感性为95.7％（95％CI 89.9-100.0％）和74.5％（95％CI 62.0-87.0％）。乳房X线照相术。乳腺X线摄影对乳房MRI的特异性分别为96.1％（95％CI 93.4-98.8％）和92.2％（95％CI 88.5-95.9％）。乳房MRI的诊断准确性不取决于乳房密度。在BI-RADS为0的病例中，n = 57（3，n = 56），乳腺MRI的敏感性为100％（90.9％），特异性为98.1％（88.9％）。在乳腺X线摄影中，BI-RADS 0的乳房中有大量致密的乳房组织（ACR IV）积聚（P <0.01）。乳房MRI遗漏了三个恶性病变，其中两个小于3毫米。结论：没有理由批评乳房MRI作为乳房X线照相术的辅助手段时特异性低。乳腺MRI的诊断准确性与乳腺密度的独立性使其成为X线钼靶X线检查0例中值得选择的选择。

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