[Magnetic resonance tomography (MRT) of the breast in problem patients]

Over the past few years MRI has become important in the evaluation of inconclusive mammograms. These studies were performed on high-field strength machines, which have the disadvantage of limited accessibility. We evaluated 185 investigations on 169 patients on a 0.5 Tesla MR machine using a dynamic sequence and gadolinium (Gd) DTPA. The results in 107 patients were correlated with the histological findings and MRI assessment proved correct in 44 of 47 benign lesions (93.6%) and 57 of 60 malignant lesions (95%). The 3 false positive results occurred in patients with mastitis, fibroadenoma and an ectatic vessel, respectively. Of the 3 false negative results 2 occurred in patients with microcarcinomas and were due to partial-volume artefacts, whilst the third was due to a technical error. These results compare with those reported in the literature using mainly high-field strength machines. Furthermore, unsuspected second tumours were diagnosed in the ipsilateral breast of 6 women and infiltration of the adjacent thoracic wall in 4 women, findings which had not been evident on mammography. Hence, our results indicate that a mild-field strength MR machine is a valuable tool not only for the non-invasive differentiation between benign and malignant lesions of the breast, but also for planning therapeutic strategy.