Role of magnetic resonance imaging in differentiation of benign and malignant breast lesions

Abstract

Objective This study was conducted to determine the role of MRI in differentiation of benign and malignant breast lesions. Background Breast MRI is an information-rich imaging modality that produces clear anatomic representation of soft tissue and also reflects underlying tissue dynamics. Patient and methods The current study included 30 female patients with clinically suspicious breast lesions. Their age ranged from 30 to 65 years. The study was conducted in Menoufia University Hospital. Cases were referred from General Surgery Department in Menoufia University Hospital. All cases were subjected to the following protocols: full history taking with special emphasis on age, parity, medications taken, previous allergic reactions, and family history of breast cancer, as well as clinical examination of both breasts to palpate any masses. An informed consent was obtained from patients included in the study. Sonomammography and dynamic contrast-enhanced (DCE) MRI were performed for all patients on high-field Toshiba Vantage1.5 T machine, respectively, in Menoufia University Hospital, Radiology Department. Results In this study the 27/30 enhanced breast lesions, their time–signal intensity curve were assessed, regarding their initial rise (slow, medium, or rapid) and their delayed phase (persistent, plateau, or washout). DCE-MRI revealed 16 (53.3%) lesions with progressive rising time/signal intensity curve (type I curve). Six (20%) lesions showed slow wash-in and slow washout with plateau curve (type II curve). Eight (26.7%) lesions showed rapid slope-up and rapid washout (type III curve). Three (10%) lesions were not enhanced. Conclusion The use of DCE-MRI decreases the number of breast biopsies taken, and it is very impressive in postsurgical follow-up (lumpectomy or mastectomy), as it can detect small lesions that can be missed by sonomammography.