72岁女性，因左乳结构扭曲进行乳房x线筛检。A.颅尾侧和B.中侧斜指侧乳腺断层合成图像显示左上外乳腺的两个AD区域(圆圈)在额外的诊断性断层合成图像上持续存在(未显示)。C.上外侧乳腺灰度横向超声图像显示不规则低回声肿块伴AD于12:30(箭头)，对应后AD。未发现超声与前AD相关。超声引导下的后AD活检显示恶性肿瘤(侵袭性小叶癌)。肿瘤合成引导下的AD前活检显示良性病理(间质纤维化)。
July 28, 2022 —According to ARRS’ American Journal of Roentgenology (AJR), for patients with multiple architectural distortion (AD) identified ondigital breast tomosynthesis(DBT),biopsyof all areas may be warranted, given the variation of pathologic diagnoses across AD in individual patients.
“Multiple AD, compared with single AD, was significantly more likely to yield high-risk pathology, but there was no significant difference in yield of malignancy,” wrote corresponding authorLilian C. Wang, MD, ofNorthwestern Medicine．在多发性AD患者中，多发性同侧或对侧AD的病理分型通常不同:良性、高风险或恶性。”
Wang and colleagues’ retrospective study included 402 patients (mean age, 56 years) who underwent image-guided core needle biopsy of AD visualized on DBT between April 7, 2017, and April 16, 2019. Patients were grouped in the single or multiple AD cohort based on the presence of distinct AD areas noted in the clinical report, while the pathologic diagnosis for each AD was based on the most aggressive pathology identified on either biopsy or surgical excision (if performed).
最终，与单一AD相比，多重AD的高风险病理发生率更高(53.0% vs. 32.5%， p=.002)，但在每个病变或每个患者的恶性肿瘤发生率上没有显著差异(31.8% vs. 28.2%， p=.56)。8/24例同侧AD活检≥2例的患者中，同侧病变病变程度不同;在5/10的对侧AD活检患者中，对侧病变病变最严重。
“To our knowledge,”the authors of this AJR article contended，“这是第一个比较DBT显示的单发和多发AD患者的病理结果的研究。”
For more information:www.arrs.org
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July 28, 2022
