CAJ | 학술논문

目的：探讨MR成像在乳腺X线摄影BI-RADS 4类乳腺病变中的应用价值。方法107例乳腺X线摄影评估为BI-RADS 4类的乳腺疾病入选本研究，分为MRI和活检两组，与病理或临床随访结果相比较，并以Fisher精确检验比较两组管理方案间的差异。结果48例MRI组中，31例乳腺病变BI-RADS评级维持4类或评级上升（≥4类），手术病理示乳腺癌29例，良性2例；17例病变评级下降（≤3类），其中3例选择手术治疗，病理结果为乳腺纤维腺瘤1例和乳腺腺病伴钙盐沉积2例，余14例随访1年以上病灶未见明显变化，MRI准确率为95.83%。59例活检组中，真阳性18例，假阴性7例，真阴性34例，准确性为88.14%，MRI组和活检组两者对乳腺癌诊断差异无统计学意义（χ2＝2.036；P＝0.154）。结论乳腺MR成像对X线摄影评估为BI-RADS 4类的病变具有细分和参考价值，可提高早期乳腺癌的检出率，减少不必要的手术及活检，并对良性病变提供更多的影像学支持。
목적：탐토MR성상재유선X선섭영BI-RADS 4류유선병변중적응용개치。방법107례유선X선섭영평고위BI-RADS 4류적유선질병입선본연구，분위MRI화활검량조，여병리혹림상수방결과상비교，병이Fisher정학검험비교량조관리방안간적차이。결과48례MRI조중，31례유선병변BI-RADS평급유지4류혹평급상승（≥4류），수술병리시유선암29례，량성2례；17례병변평급하강（≤3류），기중3례선택수술치료，병리결과위유선섬유선류1례화유선선병반개염침적2례，여14례수방1년이상병조미견명현변화，MRI준학솔위95.83%。59례활검조중，진양성18례，가음성7례，진음성34례，준학성위88.14%，MRI조화활검조량자대유선암진단차이무통계학의의（χ2＝2.036；P＝0.154）。결론유선MR성상대X선섭영평고위BI-RADS 4류적병변구유세분화삼고개치，가제고조기유선암적검출솔，감소불필요적수술급활검，병대량성병변제공경다적영상학지지。
Objective To investigate the added value of MRI in evaluating breast lesions of BI-RADS category 4.Methods 107 patients with BI-RADS category 4 assessment on mammography were randomly divided to undergo breast MRI(48)or biopsy(59). The pathology or clinical follow-up between these women were compared using the Fisher exact probability test.Results The BI-RADS category was≥4 in 31/48 lesions on MRI with 29 pathologically confirmed malignancy and 2 benign.In the 17/48 lesions with BIRADS category≤3 on MRI,3 were removed surgically with pathological diagnosis of fibroadenoma in 1 and adenosis in 2.The remaining 14 lesions were stable in the 1-year follow up.The accuracy of MRI was 95.83%.Of 59 lesions that were biopsied,18 were malignant,7 were false negative and 34 were true negative.The MRI accuracy of 95.83%was not significantly(χ2=2.036;P=0.154) higher than that of biopsy alone(88.14%).Conclusion Breast MRI can increase the detection rate of early breast cancer and reduce unnecessary biopsy and surgery.It can also increase the diagnostic confidence of benign lesions.