Purpose To evaluate feasibility of using magnetization transfer ratio (MTR) in conjunction with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for differentiation of benign and malignant breast lesions at 3 Tesla. Materials and Methods This prospective study was IRB and HIPAA compliant. DCE-MRI scans followed by MT imaging were performed on 41 patients. Region of interests (ROI’s) were drawn on co-registered MTR and DCE post-contrast images for breast structures, including benign lesions (BL) and malignant lesions (ML). Initial enhancement ratio (IER) and delayed enhancement ratio (DER) were calculated, as were normalized MTR, DER and IER (NMTR, NDER, NIER) values. Diagnostic accuracy analysis was performed. Results Mean MTR in ML was lower than in BL (p <0.05); mean DER and mean IER in ML were significantly higher than in BL (p<0.01, p<0.001). NMTR, NDER, and NIER were significantly lower in ML versus BL (p<0.007, p<0.001, p<0.001). IER had highest diagnostic accuracy (77.6%), sensitivity (86.2%), and area under the ROC curve (.879). MTR specificity was 100%. Logistic regression modeling with NMTR and NIER yielded best results for BL versus ML (sensitivity 93.1%, specificity 80%, AUC 0.884, accuracy 83.7%). Conclusion Isolated quantitative DCE analysis may increase specificity of breast MR for differentiating BL and ML. DCE-MRI with NMTR may produce a robust means of evaluating breast lesions.

Adolescent tibial tuberosity injuries are infrequent fractures usually seen in physically active adolescent males. Powerful contraction of the knee extensors by sudden acceleration or deceleration of the quadriceps muscle can result in avulsion fractures of the tibial tuberosity apophysis. In late puberty, as the growth plate closes, it is transiently replaced by fibrocartilaginous elements. This transition causes a period of weakened tensile strength, which predisposes the tibial tuberosity to traction injury. Classification of tibial tuberosity fractures includes types I-V with added A and B subsets to types I, II and III. Multidetector computed tomography (MDCT) is a useful tool to more accurately classify complex, higher grade adolescent tibial tuberosity avulsion fractures when compared to plain film. This aids in preoperative planning and, therefore, results in improved treatment and management.