Accuracy of magnetic resonance in suspicious breast lesions: a systematic quantitative review and meta-analysis

作者：Medeiros Lidia Rosi; Duarte Celia Scapin; Rosa Daniela Dornelles; Edelweiss Maria Isabel; Edelweiss Marcia; Silva Fabio Rosa; Winnnikow Erik Paul; Simoes Pires Patricia Duarte; Rosa Maria Ines^*

来源：Breast Cancer Research and Treatment, 2011, 126(2): 273-285.

DOI：10.1007/s10549-010-1326-9

• Magnetic resonance mammography
• Breast magnetic resonance
• MRI
• Systematic review
• Meta-analysis
• Breast cancer
• Diagnosis
• Sensitivity
• Specificity
• ROC

Dynamic contrast-enhanced breast magnetic resonance (MR) is a promising emerging technique for evaluating breast lesions. A quantitative systematic review was performed to estimate the accuracy of breast MR in the diagnosis of high-risk breast lesions and breast cancer. A comprehensive search of the Cochrane Library, MEDLINE, CANCERLIT, LILACS, and EMBASE databases was performed from January 1985 to August 2010. The medical subjects heading (MeSH) and text words for the terms "breast neoplasm", "breast lesions", "breast cancer" and "magnetic resonance" were combined with the MeSH term diagnosis ("sensitivity and specificity"). Studies that compared breast MR with paraffin-embedded sections parameters for the diagnosis of breast lesions (benign, high-risk borderline, and breast cancer) were included. Sixty-nine studies were analyzed, which included 9,298 women with 9,884 breast lesions. Interrater overall agreement between breast MR and paraffin section diagnosis was 79% (kappa = 0.55), indicating moderate agreement. Pooled sensitivity and specificity were 90% [95% CI 88-92%] and 75% [95% CI 70-79%], respectively. The pooled likelihood positive ratio was 3.64 (95% CI 3.0-4.2) and the negative ratio was 0.12 (95% CI 0.09-0.15). For breast cancer or high-risk lesions versus benign lesions, the AUC was 0.91 for breast MR and the point Q* was 0.84. In summary, breast MR is a useful pre-operative test for predicting the diagnosis of breast lesions.

• 出版日期2011-4