摘要
目的探讨MRI增强图像上肿瘤至乳头乳晕复合体(NAC)之间的连续强化征对术前预测乳腺癌NAC隐匿性侵犯的价值。方法前瞻性分析2017年1月~2018年9月行全乳切除术的242例乳腺癌患者术前MRI资料。根据手术病理结果确定NAC隐匿性侵犯情况,分为NAC阳性组和阴性组。比较各MRI征象在两组间的差别,计算MRI连续强化征诊断乳腺癌NAC隐匿性侵犯的敏感度、特异度、符合率、阳性预测值、阴性预测值。结果242例患者中,NAC阳性47例,阴性195例。连续强化征在两组间差异有统计学意义(P<0.001),NAC阳性组34例(72.3%)出现连续强化征,NAC阴性组11例(5.6%)出现连续强化征。其余7个MRI征象在两组间无显著差异(P=0.110~0.696)。连续强化征术前预测乳腺癌NAC隐匿性侵犯的敏感度72.3%、特异度94.4%、符合率90.1%、阳性预测值75.6%、阴性预测值93.4%。结论MRI连续强化征对乳腺癌NAC隐匿性侵犯的术前预测有一定的价值。
Objective To investigate the MRI feature of continuous enhancement from index lesion to nipple-areola complex(NAC)for preoperative prediction of occult NAC involvement in patients with breast cancer.Methods Between January 2017 and September 2018,242 patients with breast cancer were enrolled in this prospective study.The patients underwent breast MRI before radical mastectomy.They were divided into a NAC-positive and NAC-negative groups based on the pathologic results regarding NAC involvement.Preoperative MRI features such as lesion type,location,tumor size,enhancement pattern,multicentricity,tumor-to-NAC continuous enhancement,tumor-to-NAC distance and nipple retraction were compared between the two groups using Pearsonχ~2 test.The diagnostic performance of tumor-to-NAC continuous enhancement for occult NAC involvement was evaluated.Results Of the 242 breast cancer patients,47 were NAC-positive and 195 were NAC-negative.The tumor-to-NAC continuous enhancement was significantly different between NAC-positive and NAC-negative groups(P<0.001).It was present in 34(72.3%)NAC-positive patients and in 11(5.6%)NAC-negative patients.The other 7 MRI features were not significantly different between the two groups(P=0.110-0.696).Tumor-to-NAC continuous enhancement was 72.3%sensitive,94.4%specific,90.1%accurate with 75.6%positive predictive value and 93.4%negative predictive value for the diagnosis of occult NAC involvement.Conclusion Tumor-to-NAC continuous enhancement is an effective MRI feature for the preoperative prediction of occult NAC involvement in breast cancer.
作者
刘壮盛
赖婵
李青
梁克明
李儒琼
陈俊豪
龙晚生
LIU Zhuang-sheng;LAI Chan;LI Qing;LIANG Ke-ming;LI Ru-qiong;CHEN Jun-hao;LONG Wan-sheng(Department of Radiology,Jiangmen Central Hospital,Guangdong 529030,China)
出处
《影像诊断与介入放射学》
2019年第6期422-426,共5页
Diagnostic Imaging & Interventional Radiology
基金
广东省江门市科技计划项目(2017A4016)
关键词
乳腺癌
乳头乳晕复合体
磁共振成像
连续强化征
Breast cancer
Nipple-areola complex
Magnetic resonance imaging
Tumor-to-NAC continuous enhancement
