E-ISSN 1305-3612
Breast Radiology - Original Article
Ultrasound and magnetic resonance imaging in the evaluation of mammographic BI-RADS 4 and 5 microcalcifications
1 Department of Diagnostic and Interventional Radiology, University Hospital Dubrava, Zagreb, Croatia  
Diagn Interv Radiol ; : -

Abstract

PURPOSE: The aim of this study was to assess diagnostic accuracies of US and MRI in lesions that manifest as mammographic BI-RADS 4 and 5 microcalcifications, in the setting of conjoined use of mammography, US and MRI.

 

METHODS: Patients with mammographic BI-RADS 4 or 5 microcalcifications, without additional findings, were included in this prospective study. All patients subsequently underwent breast US and MRI. Histopathologic diagnosis, obtained by US guided core needle biopsy or surgical excision, served as a reference standard. Diagnostic accuracies of US and MRI were calculated, and positive predictive value for different MRI BI-RADS imaging features were determined.

 

RESULTS: The study group consisted of 113 women with 125 areas of suspicious microcalcifications. MRI reached sensitivity, specificity, PPV3 and NPV of 100%, 70.1%, 67.6% and 100%, respectively. Statistically significant differences in MRI morphological features and kinetic enhancement curves were observed between malignant and benign microcalcifications. Sensitivity, specificity, PPV3 and NPV for US were: 85.4%, 66.2%, 61.2% and 87.9%. There was statistically significant difference in presentation of malignant and benign microcalcifications at US.

 

CONCLUSION: In the setting of conjoined use of MG, US and MRI, MRI can reliably exclude malignancy in suspicious microcalcifications. Thus, negative MRI may influence decision on biopsy of microcalcifications.

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