Abstract
Purpose: To assess the role of Dynamic contrast enhanced magnetic resonance imaging in characterization of breast lesions and to differentiate benign from malignant lesions on the basis of their morphology and enhancement kinetics. Material and Methods: Sixty patients referred to the department of Radiodiagnosis for breast MRI over a period of twenty months were included. Dynamic contrast enhanced (DCE) Magnetic Resonance Imaging (MRI) was performed to differentiate breast lesions on the basis of morphology and enhancement kinetics. The lesions were classified accordingly into type I (progressive enhancement) Type II (plateau) and Type III (washout) kinetics. Morphology and curves of benign and malignant lesions were compared. Result: fifty one benign lesions were detected in 32 patients and 29 malignant lesions were seen in 22 patients, whereas six patients showed normal MRI. It was found that benign lesion were round or oval in shape with well circumscribed margin and showed homogenous contrast enhancement whereas malignant lesions were irregular with spiculated margin and showed heterogenous contrast enhancement. The distribution curve types of benign lesion were Type I (81.25%-26cases), Type II (18.25%-6cases). For malignant lesions Type I (4.54%-1case), Type II (22.72%-5cases) and Type III (72.72%-16cases). Conclusion: The shape of the time- signal intensity curve were an important criteria in differentiating benign from malignant lesions in dynamic breast MR imaging. A type III time curve is a strong indicator of malignancy and is independent of other criteria. DOI: http://dx.doi.org/10.3126/njr.v4i1.11366 Nepalese Journal of Radiology, Vol.4(1) 2014: 23-33
Highlights
Dynamic contrast enhanced (DCE) MR imaging with adequate spatial and temporalNJR I VOL 4 I No 1 I ISSUE 6 I Jan-June, 2014Issar P et al Role of Dynamic Contrast Enhanced Magnetic Resonance Imaging (MRI) in Characterizationo Breast Lesions resolution, facilitated assessment of both morphologic and enhancement kinetic features, as are described in the Standardized American college of Radiology (ACR) breast imaging reporting and Data system (BIRADS) MR Imaging Lexicon
Contra lateral 1 lesion associated with high grade ductal carcinoma in situ and type II curve (Fig.4A and B), while intra ductal linear subaerolar calcification seen on mammography in one case
Linear enhancing dilated sub aerolar ductal system with two small enhancing lesion within it seen in one case turn out to be high grade ductal carcinoma in situ with intra ductal papilloma ( 5 x 8 x 6.7mm) and type II curve (Fig. 5A and B)
Summary
Dynamic contrast enhanced (DCE) MR imaging with adequate spatial and temporalNJR I VOL 4 I No 1 I ISSUE 6 I Jan-June, 2014Issar P et al Role of Dynamic Contrast Enhanced MRI in Characterizationo Breast Lesions resolution, facilitated assessment of both morphologic and enhancement kinetic features, as are described in the Standardized American college of Radiology (ACR) breast imaging reporting and Data system (BIRADS) MR Imaging Lexicon. Dynamic contrast enhanced (DCE) MR imaging with adequate spatial and temporal. NJR I VOL 4 I No 1 I ISSUE 6 I Jan-June, 2014. Issar P et al Role of Dynamic Contrast Enhanced MRI in Characterizationo Breast Lesions resolution, facilitated assessment of both morphologic and enhancement kinetic features, as are described in the Standardized American college of Radiology (ACR) breast imaging reporting and Data system (BIRADS) MR Imaging Lexicon. New revisions of the MRI lexicon serve to further clarify breast MR imaging reporting, improve lesion diagnosis and management and facilitate patient care.[3,4]. The goal of the study was to assess the role of Dynamic contrast enhanced magnetic resonance imaging in characterization of breast lesions and to differentiate benign from malignant lesions on the basis of their morphology and signal intensity curve
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