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Herzliches Glückw ü nsch

Viel Glück. Herzliches Glückw ü nsch. Meine besten Wünsche. By: Nour-Eldin A. Nour-Eldin Ref: Werner A. Kaiser , 2008. Mri Signs of bresat mammography. 1. Round shape.

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Herzliches Glückw ü nsch

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  1. VielGlück HerzlichesGlückwünsch MeinebestenWünsche

  2. By: Nour-Eldin A. Nour-Eldin Ref: Werner A. Kaiser , 2008 Mri Signs of bresat mammography

  3. 1. Round shape The round or spherical shape is defined in the first postcontrast image, usually 90 seconds after injection of the contrast agent.

  4. Precontrast 1min Post contrast 2min Post contrast Subtraction 1min Subtraction 2min 7min Post contrast STIR image Subtraction 7min T2WI

  5. Interpretition: A round mass lesion is frequently a cyst, myxoidfibroadenoma, or papilloma. Less commonly a myxoid or medullary carcinoma may appear round, although carcinomas will show at least some evidence of peripheral infiltration into surrounding tissues. Benign

  6. 2. Oval shape An elliptical or egg shape.

  7. Precontrast 1min Post contrast 2min Post contrast Subtraction 1min Subtraction 2min 7min Post contrast STIR image Subtraction 7min T2WI

  8. Interpretition: Elliptical or oval shapes may occur with cysts, myxoidfibroadenomas, and papillomas. Myxoid carcinomas also have relatively well-defined rounded or oval margins. Circumscribed mastitis or a small noninvasive carcinoma (DCIS, approximately 5 mm in size) may have an oval shape with ill-defined margins. Benign

  9. 3. Lobulated shape An undulating contour.

  10. Precontrast 1min Post contrast 2min Post contrast Subtraction 1min Subtraction 2min 7min Post contrast STIR image Subtraction 7min T2WI

  11. Interpretition: A wavy, lobulated contour is generally the hallmark of a benign lesion, as malignancy generally does not allow for regular, harmonious, undulating contours. Benign

  12. 4. Irregular shape An uneven shape; not round, oval, or lobulated.

  13. Precontrast 1min Post contrast 2min Post contrast Subtraction 2min Subtraction 1min 7min Post contrast STIR image Subtraction 7min T2WI

  14. Interpretition: Irregular contours of a mass lesion are generally the hallmark of invasive cancers such as invasive ductal carcinoma, lobular carcinoma, and other types. Some noninvasive carcinomas may also have at least partially irregular margins. Malignant

  15. 5. Well-circumscribed Margin Lesion margins are assessed in the first postcontrast image, usually 90 seconds after the injection of 0.1 mmol/kg body weight gadolinium-DTPA.

  16. Precontrast 1min Post contrast 2min Post contrast Subtraction 1min Subtraction 2min 7min Post contrast STIR image Subtraction 7min T2WI

  17. Interpretition: Sharp, well-circumscribed margins are the hallmark of a cyst, fibrous fibroadenoma, myxoidfibroadenoma, or papilloma. Benign

  18. 6. Irregular margins Uneven margins, may be round or spiculated; characterized by thin infiltrating lines.

  19. Precontrast 1min Post contrast 2min Post contrast Subtraction 1min Subtraction 2min 7min Post contrast STIR image Subtraction 7min T2WI

  20. Interpretition: Irregular margins are typical of invasive carcinomas as well as fibrotic scars with adenosis. Inflammatory masses also tend to have irregular margins (mastitis, abscess), especially after percutaneous biopsy. Malignant

  21. 7. Blooming sign The lesion margins are sharply defined in the first postcontrast image, then become increasingly unsharp just outside the lesion.

  22. Interpretition: the blooming sign is a typical feature of invasive carcinoma. It may be caused by closely adjacent perifocal inflammation or the activation of tumor angiogenesis. Malignant

  23. 8. Contrast Sharpness Sign The lesion remains sharply defined throughout the dynamic study. Sharp margins are maintained until the last dynamic postcontrast image (usually 7 minutes after contrast injection).

  24. Precontrast 1min Post contrast 2min Post contrast Subtraction 1min Subtraction 2min 7min Post contrast STIR image Subtraction 7min T2WI

  25. Interpretition: Constant sharpness throughout the dynamic study generally signifies a benign lesion, i.e., a fibroadenoma or papilloma. Rarely, medullary carcinomas may also appear sharp throughout the dynamic scans, but in most cases they display subtle infiltrative signs and a blooming sign. Benign

  26. 9. Homogeneous Enhancement Complete, uniform enhancement in all portions of the mass.

  27. Precontrast 1min Post contrast 2min Post contrast Subtraction 1min Subtraction 2min 7min Post contrast STIR image Subtraction 7min T2WI

  28. Interpretition: Homogeneous enhancement is far more common in benign lesions such as papilloma and myxoidfibroadenoma. Some very small cancers may have this appearance, but most will show centripetal ring enhancement and fine peripheral spiculations. Benign

  29. 10. Heterogeneous Enhancement Mixed granular enhancement within the mass; nonspecific enhancement that does not show a ring pattern.

  30. Precontrast 1min Post contrast 2min Post contrast Subtraction 1min Subtraction 2min 7min Post contrast STIR image Subtraction 7min T2WI

  31. Interpretition: Heterogeneous enhancement is typical of calcified macrofibroadenoma. Benign or malignant lesions may also display this sign following percutaneous biopsy or hemorrhage.

  32. 11. Centrifugal Enhancement The enhancement is initially more pronounced at the center of the mass and then spreads toward the periphery (“filling in from inside to outside”).

  33. Interpretition: Centrifugal enhancement does not support a diagnosis of carcinoma and is much more consistent with a benign lesion. Benign

  34. 12. Centripetal Enhancement Peripheral ring enhancement occurs initially and then spreads toward the center of the mass (“filling in from outside to inside”).

  35. Precontrast 1min Post contrast 2min Post contrast Subtraction 1min Subtraction 2min 7min Post contrast STIR image Subtraction 7min T2WI

  36. Interpretition: Centripetal enhancement is the classic enhancement pattern of carcinoma. The portions of the tumor that are most viable and have the best blood supply are located at the periphery of the mass and show the greatest contrast uptake. The center of the tumor, meanwhile, is an area of necrosis, fibrosis, or hemorrhage, causing a delay in contrast uptake. Malignant

  37. 13. Dark internal septations Sharp, low-intensity, nonenhancing lines visible within the mass throughout the dynamic study.

  38. Precontrast 1min Post contrast 2min Post contrast Subtraction 1min Subtraction 2min 7min Post contrast STIR image Subtraction 7min T2WI

  39. Interpretition: Hypointense, nonenhancingseptations within a lesion are generally a benign sign, because a carcinoma wound tend to erode, infiltrate, or break down internal septa. Benign

  40. 14. Enhancing Internal Septations Lines within a mass that enhance after contrast administration.

  41. Precontrast 1min Post contrast 2min Post contrast Subtraction 1min Subtraction 2min 7min Post contrast STIR image Subtraction 7min T2WI

  42. Interpretition: Enhancing septations within a mass lesion are very suspicious for an inflammatory process (abscess) or a malignant tumor. Generally they do not indicate invasive ductal carcinoma, however. They are more characteristic of a metastasis, lymphoma, medullary carcinoma, lobular carcinoma, or an illdefined linear necrotic area within a carcinoma.

  43. 15. Segmental Enhancement Granular, triangular area of enhancement pointing toward the nipple. This sign may be present in one or more ducts. All types of enhancement curve may be seen. Usually limited to one breast.

  44. Precontrast 1min Post contrast 2min Post contrast Subtraction 1min Subtraction 2min 7min Post contrast STIR image Subtraction 7min T2WI

  45. Interpretition: A segmental, usually triangular area of enhancement pointing toward the nipple is a typical sign of noninvasive carcinoma (DCIS), particularly when it is unilateral and is relatively well demarcated from other, unaffected areas of the breast parenchyma. The segmental pattern refers to the overall collection of small foci and/or infiltrative changes, which have a granular or reticular appearance. Mastitis may appear as a triangular enhancing area, but this is uncommon. Malignant

  46. 16. Hypointensity on T2- weighted TSE images The signal intensity of the viable portions of the lesion on T2-weighted turbo spin-echo images is lower than the signal intensity of normal surrounding breast parenchyma.

  47. Precontrast 1min Post contrast 2min Post contrast 7min Post contrast Subtraction 1min Subtraction 2min STIR image Subtraction 7min T2WI

  48. Interpretition: A mass lesion whose T2-weighted signal intensity is less than or at most equal to that of the normal glandular tissue may be a carcinoma or fibrous fibroadenoma.

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