Diagnostic values of magnetic resonance imaging in mammography detected BI-RADS≥4 category calcifications with negative ultrasound results

Abstract

Objective: To assess the diagnostic value of magnetic resonance imaging (MRI) for diannosing suspicious calcification which were BI-RADS≥4 on mammography (MG) and negative on ultrasound. Methods: A total of 126 suspicious calcification lesions were included in the study. Those calcifications were classified as BI-RADS≥4 category and negative on ultrasound between January 2020 and December 2020, and lesions were examined with breast magnetic resonance imaging (MRI). Performance of MRI for diagnosing suspicious calcification was assessed based on biopsy pathologic results. Results: There was 100 benign lesions (79.37%), and 26 malignant lesions 26(20.63%). Benign calcifications were mostly presented as amorphous calcifications 68%（68/100）, while malignant calcifications were mostly presented as coarse heterogeneous calcifications 53.85%（14/26）. In malignant calcifications, 61.54% lesions were presented as mass enhancement, and mass enhancement were more common in malignant lesions than in benign lesions (61.54% vs 22.00%,P<0.001). 67.00% benign calcifications had no abnormal enhancement (P<0.001). Persistent time-signal intensity curve (TIC) suggested benign lesions (63.60% vs 11.54%, P<0.001) while wash-out curve suggested malignant lesions (73.08% vs 0%,P<0.001). The detection sensitivity of MG and MG+MRI for ultrasound-negative calcifications were 15.4% and 92.3% (P<0.001), with accuracy of 80.2%, 96.8% (P<0.001), respectively. The negative predictive value for MG and MRI+MG were 81.5% and 98.0% (P<0.001). Conclusions: MRI combined with MG has higher sensitivity, accuracy and negative predictive value than mammography alone in diagnosing suspicious calcifications of ultrasound negative results.

Keywords

• |magnetic resonance imaging|mammography|calcifications