| PrefaceMammography is currently the best imaging technique for the early detection and diagnosis of breast cancer. With the introduction of contrast agents, advances in surface coil technology, and development of new protocols, contrast agent enhanced magnetic resonance imaging has emerged as a promising modality for detection, diagnosis, and staging of breast caner. The reported sensitivity of MRI for the visualize of breast masses are very high, but the specificity differs. Now there are few researches that report the architectural feathers and the enhancement model and the correlation with the histopathology. Our research aims at exploring the correlation and bringing some clues.Materials and methodsPatients population:Women with suspicious palpable findings were eligible for the study . All twenty - six patients were consent with the trial enhanced MRI and the results were proved by pathology and clinical materials.MRI imaging:Imaging was performed on a 1.5 - T scanner( Elscint 2.0; General Electric Medical Systems) , using a dedicated receive - only breast coil (Phased Array Breast Coil; MRI Devices, GE).The MR imaging evaluation included T1 - weighted ( TR/TE 500/18) spin - echo, fast spin - echo T2 - weighted ( TR/TE 4500/96msec)and contract - enhanced spin - echo images,using the following parameters :field of view,8X14cm;matrix size 256X256;excitation , 1; slice thickness, 3. 0mm.Gradodiamide was injected, using a dose of 0. 1mmol/kg. We used the following terminology: The 0 - min image refers to the first of the acquisitions obtained during an imaging sequence, before contrast injection. The 1 - ,3 - and 6 -min images refer to the time after contrast injection.Pathology methods:Data Analysis and Image InterpretationInterpretation of images at the research site involved the lesion s intensity in T1WI and T2WI, architectural features and model in contrast - enhanced MRI.The pathological diagnosis were made by two pathologist without knowing the clinical history. They also analyzed the architectural feathers of the breast lesions and the correlations with histopathology.ResultsThe 26 eligible patients were 27 -77years old (median age,47 years old). Eleven patients(42% ) had malignant disease and 15 patients (58% ) had benign disease. The distribution of our pathologically confirmed diagnosis were as follows: 11 malignant lesions, 8 lesions with a diagnosis of invasive ductal carcinoma in situ(DCIS)Breast MR imaging has been found to be 75% accuracy in the fi-broadenoma,60% in hyperplasia, 100% in abscess and simple cyst. The accuracy was 100% in invasive ductal carcinoma and lobular carcinoma. One scar and ductal carcinoma in situ were not detected incontrast - enhanced MRI.8 invasive ductal carcinomas manifested spiculated borders with homogenous enhancement. 2 invasive lobular carcinoma had peripheral rim enhancement in the presence of central lesion enhancement slightly. One ductal carcinoma in situ had irregular enhancement. 5 abscesses had irregular rim enhancement, while a simple cyst enhanced with the presence of regular peripheral rim enhancement. 4 fibroadenoma had the presence of light enhancement, 1 lesion had the nonenhancing internal septations, 1 lesion had the marked enhancement with smooth rim. One scar had no enhancement.The lesions which manifested lobulared and irregular rim enhancement had the versery or lymph invasion of the malignant cell. The former had the presence of the budding protruding . The malignant cell which invaded the ductal and lymph tissue appeared the speculated borders.Those appears regular rim and partial capsule with the presence of the smooth rim in contrast - enhanced MRI. The central portion had the homogenous enhancement with the peripheral rim and the homogenous gradients histopathology. On the contrary, the heterogeneous gradients meant heterogeneous enhancement.ConclusionThe spiculated and heterogeneous irregular enhancement suggest the lesion is malignant; And the smooth margin ,with re... |
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