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Breast Imaging |
1 From the Departments of Radiology (C.K.K., P.M., S.K., C.L., H.H.S.) and Pathology (E.W.), University of Bonn, Sigmund-Freud-Str 25, D-53105 Bonn, Germany, and Philips Medical Systems, Hamburg, Germany (J.G.). From the 1996 RSNA scientific assembly. Received March 2, 1998; revision requested May 5; final revision received August 5; accepted October 7. Address reprint requests to C.K.K.
PURPOSE: To assess the relevance of the signal intensity time course for the differential diagnosis of enhancing lesions in dynamic magnetic resonance (MR) imaging of the breast.
MATERIALS AND METHODS: Two hundred sixty-six breast lesions were examined with a two-dimensional dynamic MR imaging series and subtraction postprocessing. Time–signal intensity curves of the lesions were obtained and classified according to their shapes as type I, which was steady enhancement; type II, plateau of signal intensity; or type III, washout of signal intensity. Enhancement rates and curve types of benign and malignant lesions were compared.
RESULTS: There were 101 malignant and 165 benign lesions. The distribution of curve types for breast cancers was type I, 8.9%; type II, 33.6%; and type III, 57.4%. The distribution of curve types for benign lesions was type I, 83.0%; type II, 11.5%; and type III, 5.5%. The distributions proved significantly different (
2 = 139.6; P < .001). The diagnostic indices for signal intensity time course were sensitivity, 91%; specificity, 83%; and diagnostic accuracy, 86%. The diagnostic indices for the enhancement rate were sensitivity, 91%; specificity, 37%; and diagnostic accuracy, 58%.
CONCLUSION: The shape of the time–signal intensity curve is an important criterion in differentiating benign and malignant enhancing lesions in dynamic breast MR imaging. A type III time course is a strong indicator of malignancy and is independent of other criteria.
Index terms: Breast neoplasms, 00.31, 00.32 • Breast neoplasms, MR, 00.121412, 00.121415, 00.12143, 00.12144 • Magnetic resonance (MR), flow studies, 00.12143, 00.12144
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