Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Assessment of Additional MRI-Detected Breast Lesions Using the Quantitative Analysis of Contrast-Enhanced Ultrasound Scans and Its Comparability with Dynamic Contrast-Enhanced MRI Findings of the Breast

유방자기공명영상에서 추가적으로 발견된 유방 병소에 대한 조영증강 초음파의 정량적 분석을 통한 진단 능력 평가와 동적 조영증강 유방 자기공명영상 결과와의 비교

  • Sei Young Lee (Department of Radiology, Korea University Guro Hospital, College of Medicine, Korea University) ;
  • Ok Hee Woo (Department of Radiology, Korea University Guro Hospital, College of Medicine, Korea University) ;
  • Hye Seon Shin (Department of Radiology, Korea University Guro Hospital, College of Medicine, Korea University) ;
  • Sung Eun Song (Department of Radiology, Korea University Anam Hospital, College of Medicine, Korea University) ;
  • Kyu Ran Cho (Department of Radiology, Korea University Anam Hospital, College of Medicine, Korea University) ;
  • Bo Kyoung Seo (Department of Radiology, Korea University Ansan Hospital, College of Medicine, Korea University) ;
  • Soon Young Hwang (Medical Science Research Support Center, Division of Medical Statistics, Korea University Guro Hospital, College of Medicine, Korea University)
  • 이세영 (고려대학교 의과대학 고려대학교 구로병원 영상의학과) ;
  • 우옥희 (고려대학교 의과대학 고려대학교 구로병원 영상의학과) ;
  • 신혜선 (고려대학교 의과대학 고려대학교 구로병원 영상의학과) ;
  • 송성은 (고려대학교 의과대학 고려대학교 안암병원 영상의학과) ;
  • 조규란 (고려대학교 의과대학 고려대학교 안암병원 영상의학과) ;
  • 서보경 (고려대학교 의과대학 고려대학교 안산병원 영상의학과) ;
  • 황순영 (고려대학교 의과대학 의과학연구지원센터 고려대학교 구로병원 통계상담실)
  • Received : 2020.06.08
  • Accepted : 2020.09.14
  • Published : 2021.07.01
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Abstract

Purpose To assess the diagnostic performance of contrast-enhanced ultrasound (CEUS) for additional MR-detected enhancing lesions and to determine whether or not kinetic pattern results comparable to dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the breast can be obtained using the quantitative analysis of CEUS. Materials and Methods In this single-center prospective study, a total of 71 additional MR-detected breast lesions were included. CEUS examination was performed, and lesions were categorized according to the Breast Imaging-Reporting and Data System (BI-RADS). The sensitivity, specificity, and diagnostic accuracy of CEUS were calculated by comparing the BI-RADS category to the final pathology results. The degree of agreement between CEUS and DCE-MRI kinetic patterns was evaluated using weighted kappa. Results On CEUS, 46 lesions were assigned as BI-RADS category 4B, 4C, or 5, while 25 lesions category 3 or 4A. The diagnostic performance of CEUS for enhancing lesions on DCE-MRI was excellent, with 84.9% sensitivity, 94.4% specificity, and 97.8% positive predictive value. A total of 57/71 (80%) lesions had correlating kinetic patterns and showed good agreement (weighted kappa = 0.66) between CEUS and DCE-MRI. Benign lesions showed excellent agreement (weighted kappa = 0.84), and invasive ductal carcinoma (IDC) showed good agreement (weighted kappa = 0.69). Conclusion The diagnostic performance of CEUS for additional MR-detected breast lesions was excellent. Accurate kinetic pattern assessment, fairly comparable to DCE-MRI, can be obtained for benign and IDC lesions using CEUS.

목적 자기공명영상에서 추가적으로 발견된 조영증강 병소에 대한 조영증강 초음파의 진단능력을 평가하고 조영증강 초음파의 정량 분석을 사용하여 유방 동적 조영증강 자기공명영상과 유사한 운동 패턴 결과를 얻을 수 있는지 분석하였다. 대상과 방법 단일 센터 전향적 연구로 진행하였고, 총 71개의 자기공명영상에서 추가적으로 발견된 조영증강 병소가 포함되었다. 이러한 병소에 대해 조영증강 초음파를 시행하였고 Breast Imaging-Reporting and Data System (이하 BI-RADS)에 따라 분류하였다. 그리고 모든 병소의 BI-RADS 분류를 조직학적 결과와 비교하여 조영증강 초음파의 민감도, 특이도 및 진단 정확도를 계산하였다. 조영증강 초음파와 동적 조영증강 자기공명영상의 운동 패턴사이의 일치도는 가중 카파 분석을 사용하여 평가되었다. 결과 조영증강 초음파에서 총 46개의 병소가 BI-RADS 4B, 4C, 5로 분류되었고, 25개의 병소가 BI-RADS 3, 4A로 분류되었다. 자기공명영상에서 추가적으로 발견된 조영증강 병소에 대한 조영증강 초음파의 진단 능력은 84.9%의 민감도, 94.4%의 특이도 및 97.8%의 긍정적 예측값으로 우수하였다. 총 57/71 (80%) 병소는 조영증강 초음파와 동적 조영증강 자기공명영상 운동 패턴 결과가 일치하였고 가중 카파 값 0.66으로 좋은 일치도를 나타냈다. 부분 군 분석에서 양성 병소는 우수한 일치를 보였고(가중 카파 값 = 0.84), 관내암종은 좋은 일치를 보였다(가중 카파 값 = 0.69). 결론 MRI에서 추가 검출된 유방 결절에 대한 조영증강 초음파의 진단 능력은 우수했다. 양성 및 관내암종 병소에서 동적 조영증강 자기공명영상과 조영증강 초음파의 운동 패턴 결과는 좋은 일치도를 보였다.

Keywords

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