Navegando por Palavras-chave "Calcifications"

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    A performance da ressonância magnética como teste diagnóstico adicional na avaliação de calcificações mamográficas suspeitas
    (Universidade Federal de São Paulo (UNIFESP), 2019-09-05) Ninno, Andrea Alves Maciel Di [UNIFESP]; Lederman, Henrique Manoel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objectives: To evaluate magnetic resonance (MRI) performance indicators as an additional method in the study of suspicious mammographic calcifications, identifying the enhancement patterns most related to malignancy and aggressiveness of carcinoma in situ. Methods: A prospective longitudinal study including 162 patients, whose mammographic screening exams showed suspicious calcifications clusters, categories 4 and 5 according to the system of BI-RADS® categorization. All patients underwent anatomopathological correlation and magnetic resonance of the breast, performed between January 2011 and July 2015 and the histological results were related to the presence and patterns of enhancement. Results: All 162 were female patients, mean age of 53 years old (34 to 82 years old) with 163 mammographic lesions. The anatomopathological biopsy results included 77/163 (47.2%) benign lesions, 64/163 (39.3%) malignant lesions and 22/163 (13.5%) precursor lesions. Benign lesions manifested enhancement in 17/77 (22.1%), malignant lesions in 56/64 (87.5%) and precursor lesions in 5/22 (22.7%). Malignant lesions were more associated with the presence of enhancement and benign lesions with the absence of it, with statistically significant results. The sensitivity, specificity and resonance accuracy values, PPV and NPV in evaluation of calcifications by MRI were 87.5%, 77.8%, 81.5%, respectively. Twenty two of 163 (13.5%) cases were PF and eight of 163 (5%) cases of NF were observed. Malignant lesions showed only suspicious enhancement 56/56 (100%), with predominance of non-nodular pattern in 38/56 (67.9%) and clumped segmental in 28/56 (50%) of the cases. In relation to in situ carcinomas we observed enhancement in 30/38 (78.9%) of the cases. High-grade DCIS exhibited enhancement in the majority 24/26 (92.3%) with a predominance of non-nodular enhancement in 17/23 (73.9%). Conclusions: MRI can be considered as an additional method for evaluating suspected mammographic calcifications, increasing specificity and PPV in comparison with mammography, especially when it presents clumped segmental enhancement. The presence of enhancement in DCIS showed a high association with high-grade lesions.