유방 병변에서 확산강조영상과 조영증강영상 소견의 비교 = Comparison of Diffusion Weighted Imaging and Contrast Enhanced Imaging on MRI for Breast Lesions

다국어 초록 (Multilingual Abstract)

Purpose: To retrospectively compare the MRI findings of diffusion-weighted imaging (DWI) and contrast-enhanced imaging (CEI) of breast lesions.
Materials and Methods: From June 2005 to June 2007, 159 patients with 159 biopsy-proven breast lesions underwent breast MRIs including DWI and CEI. Two breast imaging radiologists reviewed the MRI findings by consensus for the presence of a high signal intensity on DWI and enhancement on CEI. The MRI findings and concordance of DWI and CEI findings were correlated with the pathologic diagnosis.
Results: Of the 159 lesions 141 were malignant and 18 were benign. The sensitivity and specificity of DWI for detecting breast cancer was 96.5% (135/141) and 21.4% (5/18), respectively, compared to CEI, whose detection rate was 99.3% (140/141) and 33.3% (6/18), respectively. Larger lesions (> 1 cm) were more frequently detected by DWI. Of the enhanced malignancy, 96.4% (135/140) showed high signal intensity on DWI. The concordance of DWI and CEI findings in malignant lesions was significantly higher than benign lesions (95.7% vs. 61.1%, p<0.0001).
Conclusion: High signal intensity on diffuse-weighted MRI shows a high degree of sensitivity for detecting breast cancer.

국문 초록 (Abstract)

목적: 유방의 양성 및 악성 병변에서 확산강조영상과 조영증강영상의 소견을 비교하였다.
대상과 방법: 2005년 6월부터 2007년 6월까지 본원에서 조직 확진된 159명 환자의 159개 유방 병변을 대상으로 하였다. 환자는 모두 확산강조영상과 조영증강영상을 포함한 유방 자기공명영상을 시행하였다. 두 명의 유방영상 전문의가 확산강조영상에서 병변의 고신호 유무와 조영증강영상에서 조영증강 유무를 합의로 결정하였고, 조영증강과 고신호 소견 유무가 일치하는 경우 일치한다고 정의하였다. 유방암에 대한 두 영상 소견의 민감도, 특이도를 비교하였다. 악성과 양성 병변 각각에서 두 영상의 소견의 일치율의 차이가 있는지 보았다.
결과: 159개 병변은 141개 악성 병변과 18개 양성 병변이었다. 확산강조영상의 민감도, 특이도는 각각 96.5%(135/141), 27.8%(5/18), 조영증강영상은 각각 99.3%(140/141), 33.3%(6/18)였다. 확산강조영상의 민감도는 크기 1 cm 이상 병변(97.7%)일 때 1 cm 미만 병변(84.6%)에 비해서 높았다. 조영증강 된 악성 병변의 96.4%(135/140)가 확산강조영상에서 고신호였다. 악성 병변이 양성 병변보다 두 영상 소견 일치율이 높았다(95.7% vs. 61.1%, p < 0.0001).
결론: 확산강조영상은 유방 병변의 발견에 민감도가 높은 검사로 유방암 발견에 도움이 될 수 있다.

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