RESUMEN
Paraquat (1,1'-dimethyl-4,4'-dipyridylium) is a liquid herbicide, linked to both accidental and intentional ingestion, which can result in severe and frequently lethal poisoning. It has been known to cause injury to the lungs, kidneys, and liver. We retrospectively reviewed five cases over the last 4 years with a history of paraquat ingestion. The time duration between ingestion and high-resolution computed tomography (HRCT) was assessed. HRCT chest scan was variable, ranging from 4 to 18 days postexposure. The follow-up of the patients was also reviewed.
Asunto(s)
Herbicidas , Paraquat , Tomografía Computarizada por Rayos X , Humanos , Paraquat/envenenamiento , Herbicidas/envenenamiento , Tomografía Computarizada por Rayos X/métodos , Estudios Retrospectivos , Masculino , Adulto , Femenino , Pulmón/diagnóstico por imagenRESUMEN
Background: Malignancy of the breast is one of the most common cancers among females worldwide. Magnetic resonance mammography (MRM) is a valuable complement to conventional methods for the early diagnosis of disease, thereby providing patients with a better prognosis. The number of unnecessary biopsies and repeated excisions in cases of indeterminate breast lesions detected on conventional imaging is high. Aims: The purpose of this study was to evaluate the role of MRM in the evaluation of indeterminate breast lesions [Breast Imaging Reporting and Data System (BIRADS) 3/4] found in conventional mammography and ultrasonography (USG), taking the histopathological examination (HPE) as the gold standard. Materials and methods: A total of 38 patients with conventional radiological imaging diagnosis of indeterminate breast lesions (BIRADS 3/4) were included in this study and evaluated using contrast-enhanced MRM according to the MR-BIRADS lexicon (5th edition). Morphological characteristics of lesions were evaluated to determine the probability of malignancy. Histopathology was kept as the gold standard for comparing all the statistical parameters. Results: There were a total of 40 lesions, 35 masses, and five nonmass enhancement (NME) available for evaluation out of the 38 patients. The sensitivity of margins to detect malignancy approached 100%; however, it had a slightly lower specificity of 66.67%. Magnetic resonance imaging (MRI) showed good diagnostic performance with sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 85, 90, 89.47, 85.71, and 87.50%, respectively. Conclusion: The MRI has been shown to be useful as a problem-solving tool in breast cancer screening, clarifying indeterminate findings and avoiding unnecessary short follow-ups and percutaneous biopsies. How to cite this article: Mishra E, Kaur N, Kaur R, et al. Role of Magnetic Resonance Mammography in the Evaluation of Indeterminate Breast Lesions. J Assoc Physicians India 2023;71(11):76-84.
Asunto(s)
Neoplasias de la Mama , Imagen por Resonancia Magnética , Mamografía , Humanos , Femenino , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/patología , Imagen por Resonancia Magnética/métodos , Mamografía/métodos , Persona de Mediana Edad , Adulto , Sensibilidad y Especificidad , Anciano , Mama/diagnóstico por imagen , Mama/patología , Ultrasonografía Mamaria/métodosRESUMEN
Magnetic resonance imaging (MRI) of breasts using diffusion-weighted imaging and dynamic contrast enhancement is now well-established imaging for the evaluation and characterization of suspicious breast lesions, where it has become a problem-solving tool. Breast lesions are characterized according to their morphological features and enhancement characteristics. Breast MRI is helpful in the evaluation of breast lesions in patients with dense breasts and women with breast implants and to differentiate scars and recurrence. However, this technique has its own limitations, a few of which are elucidated in the present case report.