Magnetic resonance imaging characteristics of fibrocystic change of the breast.

OBJECTIVE: The objective of this study was to identify magnetic resonance imaging (MRI) characteristics of fibrocystic change (FCC) of the breast. MATERIALS AND METHODS: Fourteen patients with a histopathologic diagnosis of solitary FCC of the breast underwent x-ray mammography and MRI of the breast. Three experienced breast imaging radiologists retrospectively reviewed the MRI findings and categorized the lesions on morphologic and kinetic criteria according to the ACR BI-RADS-MRI Lexicon. RESULTS: The most striking morphologic feature of fibrocystic change was nonmass-like regional enhancement found in 6 of 14 (43%) FCC lesions. Based on morphologic criteria alone, 12 of 14 (86%) lesions were correctly classified as benign. According to analysis of the time-intensity curves, 10 of 14 (71%) FCC lesions were correctly classified as benign. CONCLUSION: Although FCC has a wide spectrum of morphologic and kinetic features on MRI, it most often presents as a mass or a nonmass-like regional enhancing lesion with benign enhancement kinetics.

Contrast-enhanced MRI of ductal carcinoma in situ: characteristics of a new intensity-modulated parametric mapping technique correlated with histopathologic findings.

PURPOSE: To identify morphologic and dynamic enhancement magnetic resonance imaging (MRI) features of pure ductal carcinoma in situ (DCIS) by using a new intensity-modulated parametric mapping technique, and to correlate the MRI features with histopathologic findings. MATERIALS AND METHODS: Fourteen patients with pure DCIS on pathology underwent conventional mammography and contrast-enhanced (CE) MRI using the intensity-modulated parametric mapping technique. The MR images were reviewed and the lesions were categorized according to morphologic and kinetic criteria from the ACR BI-RADS-MRI Lexicon, with BI-RADS 4 and 5 lesions classified as suspicious. RESULTS: With the use of a kinetic curve shape analysis, MRI classified seven of 14 lesions (50%) as suspicious, including four with initial-rapid/late-washout and three with initial-rapid/late-plateau. Using morphologic criteria, MRI classified 10/14 (71%) as suspicious, with the most prominent morphologic feature being a regional enhancement pattern. Using the intensity modulated parametric mapping technique, MRI classified 12/14 cases (86%) as suspicious. Parametric mapping identified all intermediate- and high-grade DCIS lesions. CONCLUSION: The intensity-modulated parametric mapping technique for breast MRI resulted in the highest detection rate for the DCIS cases. Furthermore, the parametric mapping technique identified all intermediate- and high-grade DCIS lesions, suggesting that a negative MRI using the parametric mapping technique may exclude intermediate- and high-grade DCIS. This finding has potential clinical implications.