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Segmental enhancement on breast MR images: differential diagnosis and diagnostic strategy

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Abstract

The histopathological variations of segmental enhancement on breast magnetic resonance imaging (MRI) were investigated, with the aim of identifying imaging characteristic clues to their differential diagnosis. We reviewed 70 breast MRI examinations demonstrating segmental enhancement, classified them based on their histopathology, and assessed their MRI findings as follows: (1) confluent or not confluent, (2) late enhancement pattern, and the absence or presence of (3) clustered ring enhancements and (4) surrounding high signal intensity (SI) on T2-weighted imaging. Thirteen lesions (18.5%) were benign, eight (11.5%) were high risk, 25 (36%) were ductal carcinoma in situ (DCIS) and 24 (34%) were infiltrating mammary carcinomas (IMC). Clustered ring enhancements were demonstrated in 74% of malignancies (high risk, DCIS and IMC) but no benign lesions (P = 0.0001). The surrounding high SI on T2-weighted imaging was seen in four of five IMC with marked lymphatic involvement. Clustered ring enhancement was not demonstrated in six of seven IMC of tubular and/or lobular types. Segmental enhancement was seen in not only DCIS but also IMC, high-risk and benign lesions. Clustered ring enhancement and surrounding high SI on T2-weighted imaging were clues to their differential diagnosis and helpful to decide their diagnostic strategy.

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Author notes

  1. Sachiko Yuen

    Present address: Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602–8566, Japan

Authors and Affiliations

  1. Division of Diagnostic Radiology, Shizuoka Cancer Center Hospital, Shizuoka, 411–8777, Japan

    Sachiko Yuen & Takayoshi Uematsu

  2. Division of Pathology, Shizuoka Cancer Center Hospital, Shizuoka, 411–8777, Japan

    Kasami Masako

  3. Division of Breast Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo Nagaizumi Sunto, Shizuoka, 411–8777, Japan

    Yoshihiro Uchida

  4. Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602–8566, Japan

    Tsunehiko Nishimura

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  1. Sachiko Yuen
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  2. Takayoshi Uematsu
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  3. Kasami Masako
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  4. Yoshihiro Uchida
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Correspondence to Sachiko Yuen.

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Yuen, S., Uematsu, T., Masako, K. et al. Segmental enhancement on breast MR images: differential diagnosis and diagnostic strategy. Eur Radiol 18, 2067–2075 (2008). https://doi.org/10.1007/s00330-008-0980-3

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  • DOI: https://doi.org/10.1007/s00330-008-0980-3

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