Objective: We investigated the correlations between background parenchymal enhancement (BPE) and MRI interpretations with respect to short-interval follow-ups and biopsy rates. Methods: All accessible MRI examinations...Objective: We investigated the correlations between background parenchymal enhancement (BPE) and MRI interpretations with respect to short-interval follow-ups and biopsy rates. Methods: All accessible MRI examinations from 128 women during a limited time period in 2016 were evaluated. A blinded radiologist visually categorized BPE as minimal, mild, moderate, or marked. A BI-RADS category was also assigned. We used descriptive statistics to report the findings and chi-square and Fisher’s exact tests to compare categories. Results: Prevalence of minimal, mild, moderate, and marked BPE was 14.1%, 43.0%, 32.0%, and 10.9%, respectively. The short-interval follow-up rates were 22.2%, 27.3%, 26.8%, and 7.1% in women with minimal, mild, moderate, and marked BPE, respectively. BPE was not associated with the short-interval follow-up rate (p-value = 0.477). Biopsy rates were 22.2%, 27.3%, 22.0%, and 57.1% in women with minimal, mild, moderate, and marked BPE, respectively. Although there was no significant relationship between biopsy rates and BPE levels (p-value = 0.095) in the total population, these two factors were significantly associated in premenopausal women (p-value = 0.023) and in women of 30 - 39 years (p-value = 0.001). Conclusion: Higher BPE does not correlate with short-interval follow-up rates, but appears to be related to biopsy rate, thus causing false-positives and unnecessary biopsy recommendations, particularly in younger, premenopausal women.展开更多
目的:探讨乳腺磁共振背景实质强化(BPE)与乳腺癌分子分型的相关性。方法:回顾性搜集术前行乳腺MRI检查且经病理结果证实为浸润性导管癌患者80例,分析BPE水平(a轻微;b轻度;c中度;d显著)与乳腺癌患者临床特征及病理分子分型的相关性。BPE...目的:探讨乳腺磁共振背景实质强化(BPE)与乳腺癌分子分型的相关性。方法:回顾性搜集术前行乳腺MRI检查且经病理结果证实为浸润性导管癌患者80例,分析BPE水平(a轻微;b轻度;c中度;d显著)与乳腺癌患者临床特征及病理分子分型的相关性。BPE与乳腺癌患者年龄及绝经状态之间的相关性采用Spearman相关性检验。BPE在不同乳腺癌分子分型间的差异采用卡方检验。结果:BPE与年龄呈负相关(R=-0.258,P=0.021)。BPE水平与月经状态差异有统计学意义(P=0.011),BPE水平为显著的患者多为绝经前,占58/80,BPE水平为轻微者多为绝经后患者,占65/80。80例乳腺癌中Luminal A 23例(23/80),Luminal B 30例(30/80),Her2过表达17例(17/80),三阴性10例(10/80);ER阳性53例(53/80),PR阳性43例(43/80),HER2阳性30例(30/80);Ki-67高表达48例(48/80)。卡方检验显示BPE在不同分子分型(Luminal A、Luminal B、Her2过表达、三阴性)间差异无统计学意义,P=0.392;BPE与ER、PR、HER2、Ki-67间差异亦无统计学意义(P值分别为0.259、0.067、0.138、0.869)。结论:BPE水平与年龄负相关,绝经后BPE多为轻微型。BPE水平与乳腺癌分子分型差异无统计学意义,尚不能认为BPE对预测乳腺癌分子分型有预测价值。展开更多
文摘Objective: We investigated the correlations between background parenchymal enhancement (BPE) and MRI interpretations with respect to short-interval follow-ups and biopsy rates. Methods: All accessible MRI examinations from 128 women during a limited time period in 2016 were evaluated. A blinded radiologist visually categorized BPE as minimal, mild, moderate, or marked. A BI-RADS category was also assigned. We used descriptive statistics to report the findings and chi-square and Fisher’s exact tests to compare categories. Results: Prevalence of minimal, mild, moderate, and marked BPE was 14.1%, 43.0%, 32.0%, and 10.9%, respectively. The short-interval follow-up rates were 22.2%, 27.3%, 26.8%, and 7.1% in women with minimal, mild, moderate, and marked BPE, respectively. BPE was not associated with the short-interval follow-up rate (p-value = 0.477). Biopsy rates were 22.2%, 27.3%, 22.0%, and 57.1% in women with minimal, mild, moderate, and marked BPE, respectively. Although there was no significant relationship between biopsy rates and BPE levels (p-value = 0.095) in the total population, these two factors were significantly associated in premenopausal women (p-value = 0.023) and in women of 30 - 39 years (p-value = 0.001). Conclusion: Higher BPE does not correlate with short-interval follow-up rates, but appears to be related to biopsy rate, thus causing false-positives and unnecessary biopsy recommendations, particularly in younger, premenopausal women.
文摘目的:探讨乳腺磁共振背景实质强化(BPE)与乳腺癌分子分型的相关性。方法:回顾性搜集术前行乳腺MRI检查且经病理结果证实为浸润性导管癌患者80例,分析BPE水平(a轻微;b轻度;c中度;d显著)与乳腺癌患者临床特征及病理分子分型的相关性。BPE与乳腺癌患者年龄及绝经状态之间的相关性采用Spearman相关性检验。BPE在不同乳腺癌分子分型间的差异采用卡方检验。结果:BPE与年龄呈负相关(R=-0.258,P=0.021)。BPE水平与月经状态差异有统计学意义(P=0.011),BPE水平为显著的患者多为绝经前,占58/80,BPE水平为轻微者多为绝经后患者,占65/80。80例乳腺癌中Luminal A 23例(23/80),Luminal B 30例(30/80),Her2过表达17例(17/80),三阴性10例(10/80);ER阳性53例(53/80),PR阳性43例(43/80),HER2阳性30例(30/80);Ki-67高表达48例(48/80)。卡方检验显示BPE在不同分子分型(Luminal A、Luminal B、Her2过表达、三阴性)间差异无统计学意义,P=0.392;BPE与ER、PR、HER2、Ki-67间差异亦无统计学意义(P值分别为0.259、0.067、0.138、0.869)。结论:BPE水平与年龄负相关,绝经后BPE多为轻微型。BPE水平与乳腺癌分子分型差异无统计学意义,尚不能认为BPE对预测乳腺癌分子分型有预测价值。
文摘目的回顾性分析绝经期前乳腺实质背景强化(background parenchymal enhancement,BPE)特征,探讨多模态MRI定量预测乳腺BPE的价值。方法搜集50例行乳腺MRI扩散加权成像(diffuse weighted imaging,DWI)及动态增强(dynamic contrast enhancement,DCE-MRI)检查患者影像资料,所有检查均在月经周期结束后1周内完成。依据BI-RADS 2013标准,将乳腺BPE分为轻微强化、轻度强化、中度强化及明显强化;轻微-轻度强化归为低BPE组,中度-重度强化归为高BPE组。分别对各类BPE的ADC值及DCE相关参数进行测量。DCE相关参数包括:信号增强比SER,最大上升斜率MSI,最大下降斜率MSD和正性增强积分PEI。多模态参数运用独立样本t检验及受试者特征曲线ROC进行统计分析。结果正常乳腺实质BPE区TIC曲线Ⅰ型36例,Ⅱ型11例,Ⅲ型3例。BPE呈轻微强化7例,轻度强化25例,中度强化13例,重度强化5例。32例归为低BPE,18例归为高BPE。低BPE组ADC、SER、MSI、MSD和PEI值分别为(1.46±0.32)×10-3 mm 2/s、88.18±6.81、38.62±4.58、35.38±3.83和35.22±4.36,高BPE组ADC、SER、MSI、MSD和PEI值分别为(1.34±0.11)×10-3 mm 2/s、90.15±7.90、42.19±8.26、36.07±3.61和37.98±4.15。与低BPE组比较,高BPE组的ADC值较低,且差异具有统计学意义(P<0.05);而SER、MSI、MSD和PEI值较高,但差异均无统计学意义(P均>0.05)。ROC曲线分析,以ADC=1.33×10-3 mm 2/s阈值,预测高BPE的AUC、敏感度和特异度分别为0.853、72.2%和78.1%。结论多模态MR尤其是DWI-ADC值对预测绝经期前乳腺BPE有一定帮助。
