대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제82권4호
  • /
  • Pages.889-902
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  • 2021
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  • 1738-2637(pISSN)
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  • 2288-2928(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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유방자기공명영상에서 추가적으로 발견된 유방 병소에 대한 조영증강 초음파의 정량적 분석을 통한 진단 능력 평가와 동적 조영증강 유방 자기공명영상 결과와의 비교

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

  • 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)
  • 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)
  • 투고 : 2020.06.08
  • 심사 : 2020.09.14
  • 발행 : 2021.07.01
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초록

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.

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.

키워드

참고문헌

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