Uloga magnetske rezonancije u obradi BIRADS 4 i 5 mikrokalcifikata otkrivenih mamografijom Role of breast MRI in the evaluation of mammographicaly detected BIRADS 4 and 5 microcalcifications

摘要

Objective: To determine diagnostic accuracy of breast MRI in the workup of mammographic BIRADS 4 and 5 microcalcifications.udMethods: 101 patients (age range 30 - 74 years) with 114 areas of mammographic BIRADS 4 or 5 microcalcifications were enrolled in the study. All patients underwent US, MRI and, when indicated, second-look US. Histopathological diagnosis, obtained by US guided CNB or surgical excision, was used as a reference standard for diagnostic accuracy calculations. Analysis of prevalence of different mammographical, sonographical and MRI BIRADS descriptors was performed, with calculations of PPVs for each descriptor.udResults: Sensitivity, specificity, PPV and NPV of MRI were: 100 %, 59,1 %, 69,5% and 100 %, and of US: 87,8 %, 59,1 %, 66,7 % and 83,9 %. Second-look targeted US visualized all microcalcifiactions which were not visible sonographically prior to MRI, and revealed carcinoma in 23,6 % of those cases.udConclusions: MRI can confidently exclude malignancy in mammographically suspicious microcalcifications. The negative MRI finding allows the decision not to biopsy microcalcifications. US cannot reliably exclude cancer, neither confidently differentiate benign from malignant microcalcifications. However, due to high rate of visualization of microcalcifications, US is modality of choice for the CNB guidance or preoperative wire localization.