Correlation of Lesion Appearance and Histologic Findings for the Nodes of a Breast MR Imaging Interpretation Model
Linda White Nunes, MD, MPH1,
Mitchell D. Schnall, MD, PhD2,
Susan G. Orel, MD2,
Mary G. Hochman, MD3,
Curtis P. Langlotz, MD, PhD2,
Carol A. Reynolds, MD2 and
Michael H. Torosian, MD2
1 Department of Radiology, Hahnemann University Hospital, Broad and Vine Sts, Philadelphia, PA 19102-1192 (L.W.N.)
2 Department of Radiology, University of Pennsylvania Medical Center, Philadelphia (M.D.S., S.G.O., C.P.L., C.A.R., M.H.T.)
3 Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (M.G.H.).
View larger version (29K):
[in a new window]
|
Figure 1. Diagram shows a breast imaging interpretation model that incorporates data obtained in 192 patients. Each node of the tree-shaped model includes the defining architectural feature, the number of patients with cancer and benign disease, and the associated NPV and PPV. (Adapted and reprinted, with permission, from reference 1.)
|
|
View larger version (151K):
[in a new window]
|
Figure 2. Figures 2, 3. (2) Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (25/4, 30° flip angle) shows ductal enhancement (arrow) in a 52-year-old woman with mammographically visible calcifications who proved to have DCIS. (Adapted and reprinted, with permission, from reference 1.) (3) Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (26/4, 30° flip angle) shows ductal enhancement (arrow) in a 42-year-old woman with mammographically visible calcifications who proved to have DCIS.
|
|
View larger version (141K):
[in a new window]
|
Figure 3. Figures 2, 3. (2) Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (25/4, 30° flip angle) shows ductal enhancement (arrow) in a 52-year-old woman with mammographically visible calcifications who proved to have DCIS. (Adapted and reprinted, with permission, from reference 1.) (3) Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (26/4, 30° flip angle) shows ductal enhancement (arrow) in a 42-year-old woman with mammographically visible calcifications who proved to have DCIS.
|
|
View larger version (151K):
[in a new window]
|
Figure 4. Figures 4, 5. (4) Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (28/4, 30° flip angle) shows multiple areas of regional enhancement (arrows) in a 39-year-old woman with a palpable mass who proved to have fibrocystic change. (5) Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (28/4, 30° flip angle) shows regional enhancement (arrows) in a 49-year-old woman with mammographically visible calcifications who proved to have DCIS.
|
|
View larger version (152K):
[in a new window]
|
Figure 5. Figures 4, 5. (4) Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (28/4, 30° flip angle) shows multiple areas of regional enhancement (arrows) in a 39-year-old woman with a palpable mass who proved to have fibrocystic change. (5) Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (28/4, 30° flip angle) shows regional enhancement (arrows) in a 49-year-old woman with mammographically visible calcifications who proved to have DCIS.
|
|
View larger version (136K):
[in a new window]
|
Figure 6a. T2-weighted fast spin-echo MR image (4,000/110) (a) and contrast-enhanced fast multiplanar spoiled gradient-echo MR image (50/8, 45° flip angle) (b) show a focal mass (arrow) in a 75-year-old woman with a palpable mass that was visible at mammography and that proved to be colloid carcinoma.
|
|
View larger version (148K):
[in a new window]
|
Figure 6b. T2-weighted fast spin-echo MR image (4,000/110) (a) and contrast-enhanced fast multiplanar spoiled gradient-echo MR image (50/8, 45° flip angle) (b) show a focal mass (arrow) in a 75-year-old woman with a palpable mass that was visible at mammography and that proved to be colloid carcinoma.
|
|
View larger version (126K):
[in a new window]
|
Figure 7. Figures 7, 8. (7) Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (25/4, 30° flip angle) shows a smooth mass (arrow) in a 46-year-old woman who had calcifications and a mass that were visible at mammography and that proved to represent a fibroadenoma. The thick swirls of low signal intensity seen within the mass are a variant of the nonenhancing internal septations seen in association with fibroadenoma. (Adapted and reprinted, with permission, from reference 1.) (8) Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (300/3, 90° flip angle) shows a very large smooth mass (arrows) in a 30-year-old woman with a palpable and mammographically visible mass that proved to be a giant fibroadenoma.
|
|
View larger version (151K):
[in a new window]
|
Figure 8. Figures 7, 8. (7) Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (25/4, 30° flip angle) shows a smooth mass (arrow) in a 46-year-old woman who had calcifications and a mass that were visible at mammography and that proved to represent a fibroadenoma. The thick swirls of low signal intensity seen within the mass are a variant of the nonenhancing internal septations seen in association with fibroadenoma. (Adapted and reprinted, with permission, from reference 1.) (8) Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (300/3, 90° flip angle) shows a very large smooth mass (arrows) in a 30-year-old woman with a palpable and mammographically visible mass that proved to be a giant fibroadenoma.
|
|
View larger version (127K):
[in a new window]
|
Figure 9. Figures 9, 10. (9) Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (50/8, 45° flip angle) shows a lobulated mass (white arrow) with nonenhancing internal septations in a 21-year-old woman with a palpable mass that proved to be a fibroadenoma. Black arrow indicates an internal septation. (Adapted and reprinted, with permission, from reference 1.) (10) Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (50/6, 60° flip angle) shows a lobulated mass (white arrow) with nonenhancing internal septations in a 49-year-old woman with mammographically visible calcifications who proved to have a fibroadenoma. Black arrow indicates an internal septation.
|
|
View larger version (147K):
[in a new window]
|
Figure 10. Figures 9, 10. (9) Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (50/8, 45° flip angle) shows a lobulated mass (white arrow) with nonenhancing internal septations in a 21-year-old woman with a palpable mass that proved to be a fibroadenoma. Black arrow indicates an internal septation. (Adapted and reprinted, with permission, from reference 1.) (10) Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (50/6, 60° flip angle) shows a lobulated mass (white arrow) with nonenhancing internal septations in a 49-year-old woman with mammographically visible calcifications who proved to have a fibroadenoma. Black arrow indicates an internal septation.
|
|
View larger version (136K):
[in a new window]
|
Figure 11a. T2-weighted fast spin-echo MR image (4,000/105) (a) and contrast-enhanced fast multiplanar spoiled gradient-echo MR image (50/8, 60° flip angle) (b) show a minimally enhancing lobulated mass (arrows) in a 38-year-old woman with a mammographically visible mass that proved to be a fibroadenoma.
|
|
View larger version (148K):
[in a new window]
|
Figure 11b. T2-weighted fast spin-echo MR image (4,000/105) (a) and contrast-enhanced fast multiplanar spoiled gradient-echo MR image (50/8, 60° flip angle) (b) show a minimally enhancing lobulated mass (arrows) in a 38-year-old woman with a mammographically visible mass that proved to be a fibroadenoma.
|
|
View larger version (132K):
[in a new window]
|
Figure 12a. T2-weighted fast spin-echo MR image (4,000/100) (a) and contrast-enhanced fast multiplanar spoiled gradient-echo MR image (50/6, 45° flip angle) (b) show a rim-enhancing lobulated mass (arrows) in a 40-year-old woman with a palpable and mammographically visible mass that proved to be medullary carcinoma. Peripheral rim enhancement is strongly associated with malignancy.
|
|
View larger version (134K):
[in a new window]
|
Figure 12b. T2-weighted fast spin-echo MR image (4,000/100) (a) and contrast-enhanced fast multiplanar spoiled gradient-echo MR image (50/6, 45° flip angle) (b) show a rim-enhancing lobulated mass (arrows) in a 40-year-old woman with a palpable and mammographically visible mass that proved to be medullary carcinoma. Peripheral rim enhancement is strongly associated with malignancy.
|
|
View larger version (117K):
[in a new window]
|
Figure 13a. T2-weighted fast spin-echo MR image (4,000/120) (a) and contrast-enhanced fast multiplanar spoiled gradient-echo MR image (50/6, 60° flip angle) (b) show an irregular mass (arrows) with nonenhancing internal septations in a 36-year-old woman with a palpable mass who proved to have fibrocystic change. The mass contains discrete cysts that have high T2 signal and do not enhance centrally with contrast material.
|
|
View larger version (141K):
[in a new window]
|
Figure 13b. T2-weighted fast spin-echo MR image (4,000/120) (a) and contrast-enhanced fast multiplanar spoiled gradient-echo MR image (50/6, 60° flip angle) (b) show an irregular mass (arrows) with nonenhancing internal septations in a 36-year-old woman with a palpable mass who proved to have fibrocystic change. The mass contains discrete cysts that have high T2 signal and do not enhance centrally with contrast material.
|
|
View larger version (104K):
[in a new window]
|
Figure 14. Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (25/4, 30° flip angle) shows an irregular mass (arrow) in a 47-year-old woman with a palpable and mammographically visible mass that proved to be invasive ductal carcinoma with DCIS.
|
|
View larger version (128K):
[in a new window]
|
Figure 15. Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (50/6, 45° flip angle) shows a rim-enhancing irregular mass (arrow) in a 48-year-old woman with a palpable mass that proved to be invasive ductal carcinoma with DCIS.
|
|
View larger version (126K):
[in a new window]
|
Figure 16a. T1-weighted spin-echo MR image (500/15) (a) and contrast-enhanced fast multiplanar spoiled gradient-echo MR image (50/6, 60° flip angle) (b) show a nonenhancing spiculated mass (arrow) in a 61-year-old woman with a mammographically visible mass who proved to have a radial scar and fibrocystic change.
|
|
View larger version (158K):
[in a new window]
|
Figure 16b. T1-weighted spin-echo MR image (500/15) (a) and contrast-enhanced fast multiplanar spoiled gradient-echo MR image (50/6, 60° flip angle) (b) show a nonenhancing spiculated mass (arrow) in a 61-year-old woman with a mammographically visible mass who proved to have a radial scar and fibrocystic change.
|
|
View larger version (130K):
[in a new window]
|
Figure 17. Figures 17, 18. (17) Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (25/4, 30° flip angle) shows a rim-enhancing spiculated mass (arrow) in a 69-year-old woman with a mammographically visible mass that proved to be invasive ductal carcinoma. (18) Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (25/4, 30° flip angle) shows a rim-enhancing spiculated mass (arrow) in a 64-year-old woman with mammographically visible calcifications who proved to have invasive tubular carcinoma.
|
|
View larger version (131K):
[in a new window]
|
Figure 18. Figures 17, 18. (17) Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (25/4, 30° flip angle) shows a rim-enhancing spiculated mass (arrow) in a 69-year-old woman with a mammographically visible mass that proved to be invasive ductal carcinoma. (18) Contrast-enhanced fast multiplanar spoiled gradient-echo MR image (25/4, 30° flip angle) shows a rim-enhancing spiculated mass (arrow) in a 64-year-old woman with mammographically visible calcifications who proved to have invasive tubular carcinoma.
|
|
Copyright © 1999 by the Radiological Society of North America.
