Diagnostic values of magnetic resonance imaging in mammography detected BI-RADS≥4 category calcifications with negative ultrasound results

Abstract

Abstract:

Objective:To assess the diagnostic value of magnetic resonance imaging (MRI) for diannosing suspicious calcification which were BI-RADS≥4 on mammography (MG) and negative on ultrasound.Methods:A total of 126 suspicious calcification lesions were included in the study. Those calcifications were classified as BI-RADS≥4 category and negative on ultrasound between January 2020 and December 2020, and lesions were examined with breast magnetic resonance imaging (MRI). Performance of MRI for diagnosing suspicious calcification was assessed based on biopsy pathologic results.Results:There was 100 benign lesions (79.37%), and 26 malignant lesions 26(20.63%). Benign calcifications were mostly presented as amorphous calcifications 68%（68/100）, while malignant calcifications were mostly presented as coarse heterogeneous calcifications 53.85%（14/26）. In malignant calcifications, 61.54% lesions were presented as mass enhancement, and mass enhancement were more common in malignant lesions than in benign lesions (61.54%vs22.00%,P<0.001). 67.00% benign calcifications had no abnormal enhancement (P<0.001). Persistent time-signal intensity curve (TIC) suggested benign lesions (63.60%vs11.54%,P<0.001) while wash-out curve suggested malignant lesions (73.08% vs 0%,P<0.001). The detection sensitivity of MG and MG+MRI for ultrasound-negative calcifications were 15.4% and 92.3% (P<0.001), with accuracy of 80.2%, 96.8% (P<0.001), respectively. The negative predictive value for MG and MRI+MG were 81.5% and 98.0% (P<0.001).Conclusions:MRI combined with MG has higher sensitivity, accuracy and negative predictive value than mammography alone in diagnosing suspicious calcifications of ultrasound negative results.

Key words:Magnetic resonance imaging,Mammography,Calcifications

CLC Number:

R541.7

ZHU Naiyi, JIANG Yixin, CHAI Li, CHAI Weimin. Diagnostic values of magnetic resonance imaging in mammography detected BI-RADS≥4 category calcifications with negative ultrasound results[J]. Journal of Diagnostics Concepts & Practice, 2021, 20(05): 439-444.

Figures/Tables6

MG BI-RADS	总计	良性	恶性	P值
4A类	86	80（93.02）	6（6.98）	<0.001
4B类	33	17（51.52）	16（48.48）
4C类及以上	7	3	4
总计	126	100	26

MRI BI-RADS	总计	良性	恶性	P值
2~3类	65	63（96.92）	2（3.08）	<0.001
4类及以上	61	37（60.66）	24（39.34）
总计	126	100	26

MG特征	良性	恶性	P值
钙化形态			<0.001
模糊无定形	68（68.00）	8（30.77）	<0.001
粗糙不均质	30（30.00）	14（53.85）	0.003
细小多形性	2（2.00）	2（7.69）
线状分支状	0（0）	2（7.69）	<0.001
钙化分布			0.032
区域	5（5.00）	1（3.85）
集群样	89（89.00）	17（65.38）
段样	6（6.00）	7（26.92）
线样	0（0）	1（3.85）
伴随征象			<0.001
单纯钙化	95（95.00）	21（80.77）
钙化伴肿块/不对称/ 结构扭曲	5（5.00）	5（19.23）

诊断参数	MG	MG+MRI	P值
灵敏度（%）	15.4（4/26）	92.3（24/26）	<0.001
特异度（%）	97.0（97/100）	98.0（98/100）	0.651
准确率（%）	80.2（101/126）	96.8（122/126）	<0.001
阳性预测值（%）	57.1（4/7）	85.7（24/28）	0.021
阴性预测值（%）	81.5（97/119）	98.0（98/100）	<0.001

MRI表现	良性	恶性	P值
强化			<0.001
无异常强化	67（67.0）	0（0）	<0.001
异常强化非肿块强化	11（11.0）	10（38.46）	<0.001 <0.001
肿块强化	22（22.0）	16（61.54）	<0.001
TIC			<0.001
上升型	21（63.6）	3（11.54）	<0.001
平台型	12（36.4）	4（15.38）	<0.001
流出型	0（0）	19（73.08）	<0.001

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