Iran J Radiol. 2013 Jun;10(2):99-102. doi: 10.5812/iranjradiol.4876. Epub 2013 May 20.

Breast ductal carcinoma in situ: morphologic and kinetic MRI findings.

Iranian journal of radiology : a quarterly journal published by the Iranian Radiological Society

Mirjan M Nadrljanski, Biljana B Marković, Zorica Č Milošević

PMID: 24046788 PMCID: PMC3767018 DOI: 10.5812/iranjradiol.4876

Abstract

BACKGROUND: Adequate diagnosis of ductal carcinoma in situ (DCIS) could lead to efficacious treatment. Due to the fact that DCIS lesions can progress to invasive carcinomas and that the sensitivity of the standard examination - mammography - is between 70 and 80%, use of a more sensitive diagnostic tool was needed. In detection of DCIS, contrast-enhanced magnetic resonance imaging (CE-MRI) has the sensitivity up to 96%.

OBJECTIVES: Morphological features and kinetic parameters were evaluated to define the most regular morphological, kinetic and morpho-kinetic patterns on MRI assessment of breast ductal carcinoma in situ (DCIS).

PATIENTS AND METHODS: We retrospectively assessed eighteen patients with 23 histologically confirmed lesions (mean age, 52.4 ± 10.5 years). All patients were clinically and mammographically examined prior to MRI examination.

RESULTS: DCIS appeared most frequently as non-mass-like lesions (12 lesions, 52.17%). The differences in the frequency of lesion types were statistically significant (P<0.05). The following morphological patterns were detected: A: no specific morphologic features, B: linear/branching enhancement, C: focal mass-like enhancement, D: segmental enhancement, E: segmental enhancement in triangular shape, F: diffuse enhancement, G: regional heterogeneous enhancement in one quadrant not conforming to duct distribution and H: dotted or granular type of enhancement with patchy distribution. The difference in the frequency of the proposed patterns was statistically significant (P<0.05). There were eight lesions with mass enhancement, and six with segmental lesions: regional and triangular. There was no statistically significant difference in the frequency of enhancement curve types (P>0.05). There was no significant difference in the frequency of morpho-kinetic patterns.

CONCLUSION: Non-mass-like lesions, lesions with focal or segmental distribution, with a "plateau" enhancement curve type were the most frequent findings of DCIS lesions on MRI.

Keywords: Breast Neoplasms; Carcinoma, Intraductal, Non infiltrating; Gadolinium DTPA; Image Enhancement; Magnetic Resonance Imaging

References

1. AJR Am J Roentgenol. 2008 Sep;191(3):689-99 - PubMed
2. Radiology. 2001 Jul;220(1):13-30 - PubMed
3. Radiographics. 2010 Oct;30(6):1673-87 - PubMed
4. J Natl Cancer Inst. 2004 Jun 16;96(12):906-20 - PubMed
5. J Pathol. 1995 Feb;175(2):195-201 - PubMed
6. J Natl Cancer Inst. 2002 Oct 16;94(20):1546-54 - PubMed
7. Ann Acad Med Singap. 2001 Nov;30(6):671-6; quiz 677 - PubMed
8. J Clin Oncol. 2006 Oct 1;24(28):4603-10 - PubMed
9. Radiology. 2009 Nov;253(2):281-3 - PubMed
10. Srp Arh Celok Lek. 2004 Jul-Aug;132(7-8):260-6 - PubMed
11. Radiology. 1989 Feb;170(2):411-5 - PubMed
12. Breast. 2007 Apr;16(2):161-71 - PubMed
13. Br J Radiol. 2003 Jan;76(901):3-12 - PubMed
14. Radiology. 2007 Dec;245(3):684-91 - PubMed

Publication Types

• Journal Article