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MR Imaging—Detected Breast Lesions: Histopathologic Correlation of Lesion Characteristics and Signal Intensity Data

Katja C. Siegmann1, Markus Müller-Schimpfle1, Fritz Schick1, Christopher T. Remy1, Nikos Fersis2, Peter Ruck3, Corinna Gorriz1 and Claus D. Claussen1

1 Department of Diagnostic Radiology, University Hospital Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany.
2 Department of Obstetrics and Gynecology, University Hospital Tübingen, Schleichstr. 4, 72076 Tübingen, Germany.
3 Institute of Pathology, University Hospital Tübingen, Liebermeisterstr. 8, 72076 Tübingen, Germany.



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  		Fig. 1. —Photograph shows perforated plate with integrated contrast medium—filled tube used for lesion localization and needle guidance.

 


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  		Fig. 2A. —64-year-old woman with cancer of unknown primary source and suspicious MR imaging—detected lesion of left breast. MR imaging—guided 14-gauge large-core needle biopsy with contrast-enhanced T1-weighted three-dimensional fast low-angle shot sequence was performed. Sagittal unenhanced T1-weighted MR image shows low signal intensity of parenchyma.

 


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  		Fig. 2B. —64-year-old woman with cancer of unknown primary source and suspicious MR imaging—detected lesion of left breast. MR imaging—guided 14-gauge large-core needle biopsy with contrast-enhanced T1-weighted three-dimensional fast low-angle shot sequence was performed. Second dynamic T1-weighted contrast-enhanced MR image reveals enhancing lesion (arrow).

 


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  		Fig. 2C. —64-year-old woman with cancer of unknown primary source and suspicious MR imaging—detected lesion of left breast. MR imaging—guided 14-gauge large-core needle biopsy with contrast-enhanced T1-weighted three-dimensional fast low-angle shot sequence was performed. Subtraction image obtained of unenhanced image from second contrast-enhanced T1-weighted MR image shows clearly enhancing breast lesion.

 


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  		Fig. 2D. —64-year-old woman with cancer of unknown primary source and suspicious MR imaging—detected lesion of left breast. MR imaging—guided 14-gauge large-core needle biopsy with contrast-enhanced T1-weighted three-dimensional fast low-angle shot sequence was performed. T1-weighted MR image obtained after MR imaging—guided large-core needle biopsy shows tissue defects within lesion (arrow). Histology (not shown) revealed biopsy sample was invasive ductal carcinoma.

 


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  		Fig. 3A. —55-year-old woman with suspicious enhancing lesion of left breast. MR imaging—guided lesion localization with contrast-enhanced T1-weighted three-dimensional fast low-angle shot imaging was performed. Sagittal subtraction image obtained of unenhanced from second contrast-enhanced T1-weighted MR image reveals enhancing breast lesion (arrow).

 


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  		Fig. 3B. —55-year-old woman with suspicious enhancing lesion of left breast. MR imaging—guided lesion localization with contrast-enhanced T1-weighted three-dimensional fast low-angle shot imaging was performed. Sagittal T1-weighted MR image obtained after preoperative lesion localization shows wire tip (arrow) adjacent to lesion.

 


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  		Fig. 3C. —55-year-old woman with suspicious enhancing lesion of left breast. MR imaging—guided lesion localization with contrast-enhanced T1-weighted three-dimensional fast low-angle shot imaging was performed. Transverse T1-weighted contrast-enhanced MR image reveals enhancing lesion (arrow).

 


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  		Fig. 3D. —55-year-old woman with suspicious enhancing lesion of left breast. MR imaging—guided lesion localization with contrast-enhanced T1-weighted three-dimensional fast low-angle shot imaging was performed. Transverse T1-weighted MR image after lesion localization shows wire in place. Histology (not shown) revealed lesion was fibroadenoma.

 


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  		Fig. 4. —Error chart shows mean ([UNK]) ± 2 standard deviations (SD) of maximum slope of time—signal intensity curve in benign and malignant breast lesions (n = 51), calculated as percentage per minute maximum lesion enhancement.

 


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  		Fig. 5. —Error chart shows mean ([UNK]) ± 2 standard deviations (SD) of time from contrast medium application to signal intensity peak (minutes) in benign and malignant lesions (n = 51).

 


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  		Fig. 6. —Error chart shows mean ([UNK]) ± 2 standard deviations (SD) of washout in benign and malignant lesions (n = 51), calculated as percentage of maximum lesion enhancement.

 

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