Value of DCE-MRI in the evaluation of preoperative core needle biopsy diagnosis of ductal carcinoma in situ and postoperative pathology upgrade to invasive ductal carcinoma
Objective To explore the evaluation value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in breast cancer by analyzing the MRI features of cases with ductal carcinoma in situ(DCIS)and upgraded to invasive ductal carcinoma(IDC)after surgery diagnosed by preoperative core needle biopsy(CNB).Methods The data of 104 patients with breast DCIS(including microinvasion)diagnosed by CNB admitted to the Sixth Affiliated Hospital of South China University of Technology from January 2012 to December 2022 were retrospectively analyzed.All patients underwent breast DCE-MRI.The DCE-MRI features of postoperative non-upgraded DCIS and postoperative upgraded IDC were compared,including size,morphology,edge,and internal enhancement pattern.Results Among 104 cases with DCIS by CNB before surgery,64 remained as DCIS postoperatively(including microinvasion)and 40 were postoperatively upgraded to IDC,with an upgrading ratio(pathological underestimation)of approximately 38.5%.In the non-upgraded DCIS group,there were 18 cases of mass lesions and 46 cases of non-mass lesions;in the upgraded IDC group,there were 19 cases of mass lesions and 21 cases of non-mass lesions with statistically significant differences between the two groups(P<0.05).In terms of DCE-MRI features,when the lesions appeared as non-mass enhancement,the non-upgraded DCIS mainly showed segmental distribution and heterogeneous enhancement,while the upgraded IDC mainly showed regional distribution and clustered enhancement.When the lesions appeared as mass enhancement,the non-upgraded DCIS group had clear margins,while the the upgraded IDC mostly had spiculated margins.Concerning the time-signal strength curve classification,the non-upgraded DCIS mainly showed plateau curves followed by persistent enhancing curves,while the the upgraded IDC mainly exhibited outflow curves followed by plateau curves,with statistically significant differences between the two groups(P<0.05).Conclusion Breast DCE-MRI has potential value in determining postoperative pathological upgrade of DCIS confirmed by CNB,which is conducive to the formulation of targeted treatment plans in clinical practice.
breast cancerpathological upgradeempty core needle puncture biopsydynamic enhanced magnetic resonance
万方数据
维普
