Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Incidental Breast Lesions on Chest CT: Clinical Significance and Differential Features Requiring Referral

흉부 전산화단층촬영에서 우연히 발견된 유방 병변: 임상적 중요성 및 진료 의뢰가 필요한 특징적 영상 소견

  • Choi, Yun Jung (Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Tae Hoon (Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Cha, Yoon Jin (Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Son, Eun Ju (Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Gweon, Hye Mi (Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Park, Chul Hwan (Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine)
  • 최윤정 (연세대학교 의과대학 강남세브란스병원 영상의학과) ;
  • 김태훈 (연세대학교 의과대학 강남세브란스병원 영상의학과) ;
  • 차윤진 (연세대학교 의과대학 강남세브란스병원 병리학과) ;
  • 손은주 (연세대학교 의과대학 강남세브란스병원 영상의학과) ;
  • 권혜미 (연세대학교 의과대학 강남세브란스병원 영상의학과) ;
  • 박철환 (연세대학교 의과대학 강남세브란스병원 영상의학과)
  • Received : 2018.05.24
  • Accepted : 2018.07.14
  • Published : 2018.12.01
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Abstract

Purpose: To evaluate the CT features of incidental breast lesions on chest CT and to suggest useful criteria for referral to a specialized breast unit. Materials and Methods: Between May 2009 and April 2014, enhanced chest CT examination reports containing the key word 'breast' were reviewed retrospectively. Patients who had incidental breast lesion and were referred to a specialized breast unit and then underwent pathological confirmation or follow-up over a 1-year period were included. Finally, 86 patients (all female, mean age, $48.9{\pm}12.6years$) were enrolled. Two radiologists evaluated lesion characteristics, including size, shape, margins, and enhancement. The correlations between the CT features and pathologies were evaluated, and the diagnostic accuracy of CT features in various combinations was assessed. Results: Among the CT features, irregular shape, non-circumscribed margin, and high contrast enhancement were different between malignant and benign lesions (p < 0.05). The combination of non-circumscribed margin and high contrast enhancement had the highest accuracy (97.7%). Conclusion: Reliable CT features for incidental malignant breast masses are irregular shape, non-circumscribed margin, and high contrast enhancement. The combination of non-circumscribed margin and high contrast enhancement could help distinguish incidental malignant breast lesions and indicate referral to a specialized breast unit.

목적: 이 연구의 목적은 흉부 전산화단층촬영(CT)에서 우연히 발견된 유방 병변의 임상적 중요성을 평가하고 유방 전문 진료 의뢰가 필요한 영상 소견을 제안하는 것이다. 대상과 방법: 2009년 5월부터 2014년 4월까지 촬영된 조영증강 흉부 CT 중에서 판독문에 '유방'이라는 단어가 포함된 검사를 후향적으로 검토하였다. 이 중 우연히 발견된 유방 병변으로 유방 초음파와 유방 촬영술을 한 뒤, 병리학적 확인이나 1년 이상의 추적 관찰을 받은 총 86명의 환자(모두 여성, 평균 연령, $48.9{\pm}12.6$세)를 대상으로 하였다. 흉부 CT에서 유방 병변의 크기, 위치, 모양, 경계 및 조영 증강을 포함한 영상 특징을 평가하였다. 다양한 CT 특징과 병리소견과의 연관성을 평가하고 여러 조합의 CT 특징의 진단 정확도를 평가하였다. 결과: 흉부 CT에서 우연히 발견된 유방 병변 중 악성 종양은 16.3%(14/86)였다. 악성 병변은 양성 병변에 비해 불규칙한 모양, 불분명한 경계, 높은 조영증강을 보였다. CT 특징의 조합 중 불분명한 경계와 높은 조영증강의 조합이 악성 병변을 예측하는데 가장 높은 정확도를 보였다(97.7%). 결론: 흉부 CT에서 우연히 발견된 유방 병변의 16.3%는 악성이었으며, 불분명한 경계와 높은 조영증강을 동시에 보일 경우 악성 가능성이 높으므로, 정확한 진단을 위해 유방 전문 진료 의뢰가 필요하다.

Keywords

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