Focal Breast Lesions - Assessment with Dynamic Contrast-enhanced Magnetic Resonance Imaging

FOCAL BREAST LESIONS-ASSESSMENT WITH DYNAMIC CONTRAST-ENHANCED MAGNETIC RESONANCE IMAGING (Abstract): Aim: To evaluate breast magnetic resonance imaging for the characterization of the breast lesions and compare to pathology. Material and methods: Our study included 64 subjects aged 21 to 76 years with newly discovered breast lesions by mammography and ultrasound who underwent contrast -enhanced MRI at Arcadia Medical Center, Iași between January and December 2016. The following were analyzed: lesion morphology (shape, contour and signal intensity), enhancement pattern and enhancement curve. Results and discussion: Of the total of 65 subjects 44 presented benign lesions and 20 malignant lesions. Lesion morphology was consistent with the pathological diagnosis in 59 cases (90.8%). The shape of the masses was mostly oval or round in the benign lesions (29 cases) and mostly irregular in the malignant ones (11 cases). The contour was lobular in 27 benign masses and irregular in 16 malignant lesions. Regarding signal intensity of the lesions we found that the cysts had a water signal intensity and the solid l esions various combinations of signals. Conclusions: The rapid upslope of the enhancement curve either the first 2 minutes is associated with malignancy and a plateau in the delayed phase with an uncertain diagnosis of malignancy. Benign lesions were round or oval, with well defined, smooth or lobulated margins, low signal intensity in T1 weighed images, high signal intensity in T2 weighted images, homogenous contrast uptake, persistent enhancement curve (fibroadenomas and fibrocystic changes) and no enhancement (cysts). Breast cancer is an irregular mass, with irregular or spiculated margins, variable signal intensity in T1 and T2 weighted images, heterogeneous contrast enhancement and washout enhancement curve.