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21.05.14 |
StefanDelorme
Division ofRadiology
Outline
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Types of breast cancer
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Imaging methods and features
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Mammography
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Ultrasound
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CT
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MRI
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T stages
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Nodal drainage and N Stages
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Treated breast cancer
21.05.14 |
StefanDelorme
Division ofRadiology
Sequences
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Must:
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T2w
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STIR (fat-suppressed T2)
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T2 TSE
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T1 dynamic
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3D-FLASH (104 slices, 0.8x0.6x1.5 mm, 5x3 min)
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0.2 mmol/kg BW Gd-DTPA
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Optional:
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DWI
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Silicon-sensitive for Implants
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Fat-suppressed T1w
21.05.14 |
StefanDelorme
Division ofRadiology
Signs of breast cancer at MR mammography
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Focal contrast enhancement
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Early rise in intensity + plateau or washout
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Contrast enhancement from periphery to center
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Shape and architecture like in mammography or US
21.05.14 |
StefanDelorme
Division ofRadiology
Be aware of benign lesions
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Multiple small contrast enhancing spots (starry sky)
➡
Benign proliferative changes = normal
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Smooth, enhancing tumors
➡
Mostly fibroadenomas
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Bean-shaped, enhancing lymph nodes
➡
Intramammary lymph nodes
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Cysts with enhancing wall
➡
Inflammatory reaction
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Complex lesions with contrast enhancement post-op
➡
Fat necrosis
➡
Look for fat or hemoglobin degradation products
21.05.14 |
StefanDelorme
Division ofRadiology
Weightings
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T1
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Sensitive for susceptibility (blood,
electro-coagulators, clips, large
calcifications)
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For post contrast imaging
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T2
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Cysts
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Edema
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Lymph nodes
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Fatty secretion
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Implants
21.05.14 |
StefanDelorme
Division ofRadiology
High versus Low Resolution