TVUS is as efficient as MRI for the diagnosis of adenomyosis in women without myoma, while MRI could be recommended for women with associated leiomyoma.

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Adding conventional imaging to NMLE lesion characterization at breast MR imaging improved the diagnostic performance of radiologists, and the interpretation model used offers good accuracy with the potential to optimize the reproducibility of NMLE analysis at MR imaging.

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PURPOSE We evaluated the addition of breast magnetic resonance imaging (MRI) to standard radiologic evaluation on the re-intervention rate in women with ductal carcinoma in situ (DCIS) undergoing breast-conserving surgery. PATIENTS AND METHODS Women with biopsy-proven DCIS corresponding to a unifocal microcalcification cluster or a mass less than 30 mm were randomly assigned to undergo MRI or standard evaluation. The primary end point was the re-intervention rate for positive or close margins (< 2 mm) in the 6 months after randomization ( ClinicalTrials.gov identifier: NCT01112254). RESULTS A total of 360 patients from 10 hospitals in France were included in the study. Of the 352 analyzable patients, 178 were randomly assigned to the MRI arm, and 174 were assigned to the control arm. In the intent-to-treat analysis, 82 of 345 patients with the assessable end point were reoperated for positive or close margins within 6 months, resulting in a re-intervention rate of 20% (35 of 173) in the MRI arm and 27% (47 of 172) in the control arm. The absolute difference of 7% (95% CI, −2% to 16%) corresponded to a relative reduction of 26% (stratified odds ratio, 0.68; 95% CI, 0.41 to 1.1; P = .13). When considering only the per-protocol population with an assessable end point, the difference was 9% (stratified odds ratio, 0.59; 95% CI, 0.35 to 1.0; P = .05). Total mastectomy rates were 18% (31 of 176) in the MRI arm and 17% (30 of 173) in the control arm (stratified P = .93). For 100 lesions seen on MRI, nonmass-like enhancement was more predominant (82%) than mass enhancement (20%). Nevertheless, no specific morphologic and kinetic parameters for DCIS were identified. CONCLUSION The study did not show sufficient surgical improvement with the use of preoperative MRI to be clinically relevant in DCIS staging. However, this could be reconsidered with the improvement of new MRI sequences and new modalities in magnetic resonance techniques.

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The purpose of this study was to describe magnetic resonance findings of intradural spinal canal secondaries and to select the best way of investigating this condition. Thirty patients with a known malignancy [breast carcinoma (n = 14), lung carcinoma (n = 10), other sites (n = 6)] and unexplained neurologic signs were studied with pre- and post-contrast T1-weighted images and T2-weighted images. Cerebrospinal fluid cytology was available in 16 patients and positive in 11 patients. In all the patients, post-contrast T1-weighted images demonstrated abnormal enhanced lesions. Most of them were nodular, located on the conus medullaris and the cauda equina. Few lesions appeared at the thoracic or cervical levels, as nodular or thin areas of enhancement. Pre-contrast T1-weighted sequences failed or were equivocal to detect the lesions. Eighteen of 30 patients had cerebral metastases. Fourteen had osseous metastases. In conclusion, post-contrast T1-weighted sequence is the optimal modality for the diagnostic of intradural spinal canal metastases. Axial and coronal images may be a useful adjunct to precise anatomic changes. T1-weighted and T2-weighted sequences remain necessary when further information is expected on vertebra or soft tissue.