Chenyu Zhang, Quankun Lin, Wei Zhai, Feng Cheng, Lu Sen, Baosan Han
{"title":"乳房磁共振成像病灶的特征和病理结果：系统回顾和荟萃分析。","authors":"Chenyu Zhang, Quankun Lin, Wei Zhai, Feng Cheng, Lu Sen, Baosan Han","doi":"10.1002/jmri.29811","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Although T2-weighted imaging (T2WI) hypointensity, delayed enhancement washout pattern, interval growth, and new appearance of a focus have been associated with malignancy, the results are not consistent.</p><p><strong>Purpose: </strong>To investigate the malignancy rate and identify the clinical and imaging characteristics associated with malignancy among foci in breast MRI.</p><p><strong>Study type: </strong>Meta-analysis.</p><p><strong>Subjects: </strong>32 articles with 2645 foci.</p><p><strong>Field strength/sequence: </strong>1.5 T and 3.0 T. T1WI, T2WI, and DCE-MRI.</p><p><strong>Assessment: </strong>PubMed, Embase, Scopus, and Cochrane databases were searched for articles published from January 2013 to December 2023, using the search terms: \"focus,\" \"foci,\" \"small mass,\" \"size,\" \"breast magnetic resonance imaging,\" and \"breast MRI.\" Extracted data included the reference standard, number of benign/malignant foci, size criterion, BI-RADS categories, amount of fibroglandular tissue, background parenchymal enhancement, T2WI signal intensity, delayed enhancement pattern.</p><p><strong>Statistical tests: </strong>Pooled data were analyzed using Revman 5.4 software. Between-study heterogeneity was investigated with I<sup>2</sup>-statistics. If I<sup>2</sup> < 50% (reflecting no substantial heterogeneity), a fixed effects model was used for analysis. If I<sup>2</sup> > 50%, random effects model analysis was used. For continuous variables, the standardized mean difference (SMD) and 95% confidence interval (CI) were used to represent the results. Malignancy rate of each study was transformed via the Freeman-Tukey Doublearcsine method. Odds ratios (OR) with 95% CIs were calculated for dichotomous variables. p values ≤ 0.05 were considered significant.</p><p><strong>Results: </strong>The pooled malignancy rate of 2645 foci was 16% (95% CI: 13%-19%). There was a significant association between malignant foci and older age (OR = 5.82, 95% CI: 2.08-9.56), T2WI hypointensity (OR = 2.28, 95% CI: 1.19-4.35) and delayed enhancement washout pattern (OR = 2.78, 95% CI: 1.87-4.12). Hyperintense foci were significantly more likely to be benign (OR = 0.41, 95% CI: 0.21-0.79).</p><p><strong>Data conclusion: </strong>An enhancing focus with T2WI hypointensity and a washout pattern, especially in older patients, is significantly more likely to be malignant. Therefore, careful attention should be paid to it and could justify consideration of biopsy.</p><p><strong>Evidence level: </strong>3.</p><p><strong>Technical efficacy: </strong>Stage 3.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Characteristics and Pathologic Results of Foci on Breast Magnetic Resonance Imaging: A Systematic Review and Meta-Analysis.\",\"authors\":\"Chenyu Zhang, Quankun Lin, Wei Zhai, Feng Cheng, Lu Sen, Baosan Han\",\"doi\":\"10.1002/jmri.29811\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Although T2-weighted imaging (T2WI) hypointensity, delayed enhancement washout pattern, interval growth, and new appearance of a focus have been associated with malignancy, the results are not consistent.</p><p><strong>Purpose: </strong>To investigate the malignancy rate and identify the clinical and imaging characteristics associated with malignancy among foci in breast MRI.</p><p><strong>Study type: </strong>Meta-analysis.</p><p><strong>Subjects: </strong>32 articles with 2645 foci.</p><p><strong>Field strength/sequence: </strong>1.5 T and 3.0 T. T1WI, T2WI, and DCE-MRI.</p><p><strong>Assessment: </strong>PubMed, Embase, Scopus, and Cochrane databases were searched for articles published from January 2013 to December 2023, using the search terms: \\\"focus,\\\" \\\"foci,\\\" \\\"small mass,\\\" \\\"size,\\\" \\\"breast magnetic resonance imaging,\\\" and \\\"breast MRI.\\\" Extracted data included the reference standard, number of benign/malignant foci, size criterion, BI-RADS categories, amount of fibroglandular tissue, background parenchymal enhancement, T2WI signal intensity, delayed enhancement pattern.</p><p><strong>Statistical tests: </strong>Pooled data were analyzed using Revman 5.4 software. Between-study heterogeneity was investigated with I<sup>2</sup>-statistics. If I<sup>2</sup> < 50% (reflecting no substantial heterogeneity), a fixed effects model was used for analysis. If I<sup>2</sup> > 50%, random effects model analysis was used. For continuous variables, the standardized mean difference (SMD) and 95% confidence interval (CI) were used to represent the results. Malignancy rate of each study was transformed via the Freeman-Tukey Doublearcsine method. Odds ratios (OR) with 95% CIs were calculated for dichotomous variables. p values ≤ 0.05 were considered significant.</p><p><strong>Results: </strong>The pooled malignancy rate of 2645 foci was 16% (95% CI: 13%-19%). There was a significant association between malignant foci and older age (OR = 5.82, 95% CI: 2.08-9.56), T2WI hypointensity (OR = 2.28, 95% CI: 1.19-4.35) and delayed enhancement washout pattern (OR = 2.78, 95% CI: 1.87-4.12). Hyperintense foci were significantly more likely to be benign (OR = 0.41, 95% CI: 0.21-0.79).</p><p><strong>Data conclusion: </strong>An enhancing focus with T2WI hypointensity and a washout pattern, especially in older patients, is significantly more likely to be malignant. Therefore, careful attention should be paid to it and could justify consideration of biopsy.</p><p><strong>Evidence level: </strong>3.</p><p><strong>Technical efficacy: </strong>Stage 3.</p>\",\"PeriodicalId\":16140,\"journal\":{\"name\":\"Journal of Magnetic Resonance Imaging\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-05-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Magnetic Resonance Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jmri.29811\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Magnetic Resonance Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jmri.29811","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Characteristics and Pathologic Results of Foci on Breast Magnetic Resonance Imaging: A Systematic Review and Meta-Analysis.
Background: Although T2-weighted imaging (T2WI) hypointensity, delayed enhancement washout pattern, interval growth, and new appearance of a focus have been associated with malignancy, the results are not consistent.
Purpose: To investigate the malignancy rate and identify the clinical and imaging characteristics associated with malignancy among foci in breast MRI.
Study type: Meta-analysis.
Subjects: 32 articles with 2645 foci.
Field strength/sequence: 1.5 T and 3.0 T. T1WI, T2WI, and DCE-MRI.
Assessment: PubMed, Embase, Scopus, and Cochrane databases were searched for articles published from January 2013 to December 2023, using the search terms: "focus," "foci," "small mass," "size," "breast magnetic resonance imaging," and "breast MRI." Extracted data included the reference standard, number of benign/malignant foci, size criterion, BI-RADS categories, amount of fibroglandular tissue, background parenchymal enhancement, T2WI signal intensity, delayed enhancement pattern.
Statistical tests: Pooled data were analyzed using Revman 5.4 software. Between-study heterogeneity was investigated with I2-statistics. If I2 < 50% (reflecting no substantial heterogeneity), a fixed effects model was used for analysis. If I2 > 50%, random effects model analysis was used. For continuous variables, the standardized mean difference (SMD) and 95% confidence interval (CI) were used to represent the results. Malignancy rate of each study was transformed via the Freeman-Tukey Doublearcsine method. Odds ratios (OR) with 95% CIs were calculated for dichotomous variables. p values ≤ 0.05 were considered significant.
Results: The pooled malignancy rate of 2645 foci was 16% (95% CI: 13%-19%). There was a significant association between malignant foci and older age (OR = 5.82, 95% CI: 2.08-9.56), T2WI hypointensity (OR = 2.28, 95% CI: 1.19-4.35) and delayed enhancement washout pattern (OR = 2.78, 95% CI: 1.87-4.12). Hyperintense foci were significantly more likely to be benign (OR = 0.41, 95% CI: 0.21-0.79).
Data conclusion: An enhancing focus with T2WI hypointensity and a washout pattern, especially in older patients, is significantly more likely to be malignant. Therefore, careful attention should be paid to it and could justify consideration of biopsy.
期刊介绍：
The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.
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