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Suspicious breast lesions: MR imaging with radiologic-pathologic correlation
S G Orel1, M D Schnall, V A LiVolsi
1Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
Purpose:
To study the architecture and enhancement characteristics of breast lesions with magnetic resonance imaging.
Materials And Methods:
Forty-one patients with mammographic and/or palpable lesions were imaged. T1-weighted, fat-saturated T2-weighted fast spin-echo, and gadolinium-enhanced and -unenhanced fat-saturated spoiled gradient-echo images were obtained. All patients underwent excisional biopsy or cyst aspiration.
Results:
Fifteen of 16 carcinomas were identified and exhibited at least partially irregular borders. T2-weighted signal intensity and contrast enhancement varied. Rim enhancement was seen in five lesions. Nine of 10 fibroadenomas were visualized and showed well-defined borders. T2-weighted signal intensity and contrast enhancement varied and correlated with histologic features. Internal septations were seen in five lesions. Time-intensity curves showed no statistically significant difference between fibroadenomas and cancers.
Conclusion:
There is an overlap in the signal intensity characteristics and enhancement profiles of benign and malignant lesions. However, border characteristics, internal architecture, enhancement characteristics, and the presence of multiple tiny associated cysts may be important clues to lesion identification.