多模态超声评估MRI中的肿块和非肿块增强：特发性肉芽肿性乳腺炎与乳腺癌的诊断准确性

Multimodal ultrasound assessment of mass and non-mass enhancements by MRI: Diagnostic accuracy in idiopathic granulomatous mastitis and breast cancer

BREAST

影响因子:7.9

分区:医学2区 / 妇产科学2区肿瘤学2区

发表日期:2024 Dec

作者: Liang Yin, Xi Wei, Qing Zhang, Lingling Xiang, Yun Zhang, Deqian Wang, Peiqin Chen, Xuan Cao, Zakari Shaibu, Rong Qin

DOI: 10.1016/j.breast.2024.103797

摘要

特发性肉芽肿性乳腺炎（IGM）由于其多样的临床和影像表现，常常模仿恶性肿瘤，诊断具有挑战性。本研究旨在评估多模态超声在动态增强MRI（DCE-MRI）中对IGM和乳腺癌的肿块和非肿块增强的诊断效果。采用回顾性分析，包括经组织学确诊的IGM和乳腺癌患者。所有患者均接受常规超声（C-US）、超声弹性成像（UE）、造影超声（CEUS）及DCE-MRI检查。经验丰富的放射科医师进行盲评，评估影像表现。计算肿块增强（ME）和非肿块增强（NME）的诊断准确性、敏感性和特异性。对于肿块增强（ME），多模态超声表现出较强的诊断效能（AUC=0.8651，95% CI：0.7431至0.9871），在鉴别IGM与乳腺癌方面具有较高的敏感性（83.3%）和特异性（92.4%）。然而，对于非肿块增强（NME），多模态超声的准确性有限（AUC=0.6306），其在区分IGM与乳腺癌时的敏感性（65.6%）和特异性（81.2%）较低。总的来说，多模态超声在DCE-MRI中对肿块增强的诊断效果良好，而对于非肿块增强表现，DCE-MRI仍是评估该疾病复杂性的最有价值的影像学方法。

Abstract

Idiopathic granulomatous mastitis (IGM) poses diagnostic challenges due to its diverse clinical and radiological presentations, often mimicking malignancies. This study aimed to assess the diagnostic efficacy of multimodal ultrasound for mass and non-mass enhancements in Dynamic Contrast-Enhanced MRI (DCE-MRI) of IGM and breast cancer.A retrospective analysis involved patients confirmed histopathologically with IGM and BC. All patients underwent conventional ultrasound (C-US), ultrasound elastography (UE), contrast-enhanced ultrasound (CEUS), and DCE-MRI examinations. Blinded experienced radiologists assessed imaging findings. Diagnostic accuracy, sensitivity, and specificity were calculated for mass and non-mass enhancements.For mass enhancements (ME), multimodal ultrasound demonstrated strong efficacy (AUC = 0.8651, 95 % CI: 0.7431 to 0.9871), exhibiting high sensitivity (83.3 %) and specificity (92.4 %) in differentiating IGM from breast cancer. However, for non-mass enhancements (NME), multimodal ultrasound showed limited accuracy (AUC = 0.6306) with lower sensitivity (65.6 %) and specificity (81.2 %) in distinguishing between IGM and breast cancer.Multimodal ultrasound displayed good diagnostic efficacy for mass enhancements in DCE-MRI for IGM and breast cancer, while for non-mass enhancement patterns, DCE-MRI remains the most valuable radiological modality for comprehensively assessing this condition's complexities.