title: A comparative study of the diagnostic value of contrast-enhanced breast MR imaging and mammography on patients with BI-RADS 3-5 microcalcifications.
abstract: OBJECTIVE
  To retrospectively investigate the diagnostic value of breast MRI in patients with BI-RADS 3-5 microcalcifications in mammography.
  
  
  METHODS
  Eighty-four patients with BI-RADS 3-5 microcalcifications on mammography underwent breast MR exams before surgical biopsy with a hookwire position under mammographic guidance. Two radiologists reviewed each lesion with BI-RADS by consensus. The diagnostic value of mammography and MRI was compared.
  
  
  RESULTS
  Histopathological examination revealed 49 benign lesions and 42 malignant lesions. In the assessments of mammography, 21 lesions (23.1%) were assigned to category 3, 51 lesions (56.0%) to category 4, and 19 lesions (20.9%) to category 5. The area under the receiver operating characteristic(ROC) curve for mammography and MR assessment was 0.844, and 0.945, respectively (p<0.05). In cases of category 3 microcalcifications, the specificity of mammography and MR was 100%, and 95.2% (p = 1.000), respectively. In cases of category 4 microcalcifications, the specificity, PPV and accuracy of mammography was 0%, 45.1% and 45.1%; whereas those for MR was 82.1% (p<0.05), 80.8% (P = 0.003) and 86.3% (p<0.05). All microcalcifications of category 5 were correctly diagnosed by mammography and MR.
  
  
  CONCLUSIONS
  Breast MRI has the potential to significantly improve the diagnosis of category 4 microcalcifications on mammography. Among mammographic category 4 microcalcifications, about 82% of benign lesions can be degraded to BI-RADS 1∼3 by MRI. However for microcalcifications of category 3 and 5, MR exams do not show significant improvement over mammography.
authors.affiliation: Department of Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Erni
authors.initials: E
authors.lastname: Li
authors.affiliation: Department of Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Xue
authors.affiliation: Department of Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Chunwu
authors.initials: C
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D002114:Calcinosis; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000379:methods; D042361:Mammary Glands, Human / Q000473:pathology*; D008327:Mammography / Q000379:methods; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results
chemical_list: D003287:Contrast Media