Diagnostic Value of 3D Fast Low-Angle Shot Dynamic MRI of Breast Papillomas

Son, Eun Ju; Kim, Min Jung; Kim, Jeong Ah; Kwak, Jin Young; Jeong, Joon

doi:10.3349/ymj.2009.50.6.838

Cited by 19 publications

(13 citation statements)

References 15 publications

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“…Although a correlation between histopathology and MRI was not the goal of our study, we noted good agreement between the dimensions estimated on MRI and those measured on the pathological sample. This is at variance with previous reports in which MRI measurements were frequently overestimated [35,36].…”

Section: Discussioncontrasting

confidence: 99%

Untitled

2018

Int J Biol Instrum

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Purpose: To determine the role and the diagnostic accuracy of breast Magnetic Resonance Imaging in the evaluation of patients with suspicious discharge from the nipple. Methods: 79 patients with suspicious nipple discharge underwent 3 Tesla MRI. Images were acquired with T2-IDEAL sequences, diffusion-weighted sequences as well as 3D T1-weighted sequences before and after the administration of 0.1 mmol/kg of gadobenate dimeglumine. MRI findings were classified according to Breast Imaging Reporting and Data System criteria as benign (BIRADS 1-2-3) or malignant (BIRADS 4-5). Reference diagnoses were based on histologic samples obtained at surgery for 51 patients and on clinical and instrumental follow-up over 24 months for 28 patients. Results: MRI identified 32 cases of BIRADS 4-5, 27 of which were found to be malignant at histological examination. In the 47 cases classified as BIRADS 1-2-3, 17 lesions were confirmed as benign by definitive histological examination, 2 lesions were found to be a malignant tumor and 28 patients had negative follow-up at 24 months. Sensitivity, specificity and diagnostic accuracy of MRI were respectively 93.1%, 90% and 91.1% with a positive predictive value of 84.3% and negative predictive value of 95.7%. The performance of MRI was also evaluated in comparison of positive cases of mammography and ultrasound. Conclusion: Breast MRI is an accurate method in the evaluation of patients with suspicious nipple secretion. A negative MRI can direct patients to follow-up rather than surgery.

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Section: Discussioncontrasting

confidence: 99%

Untitled

2018

Int J Biol Instrum

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“…Papillomas that do not enhance any contrast and that do not contour in T2-W images can be classified as MR-occult papillomas, which, in this study, explained our MRI-negative patients who were diagnosed as having ductoscopy and pathology. Several studies reported varying MR-occult papilloma rates; however, in a study by Son et al ( 26 ), all disease was detected using MRI, and MRI sensivity was reported as 100% ( 26 ). Tominaga et al ( 27 ) classified papillomas into four MRI types by grouping them according to their pathologic features; solid and cystic masses were reported in addition to the literature.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Nipple Discharge: Value of Magnetic Resonance Imaging and Ultrasonography in Comparison with Ductoscopy

Yılmaz¹,

Bender²,

Yabul³

et al. 2017

Balkan Med J

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Background:Pathologic nipple discharge, which is a common reason for referral to the breast imaging service, refers to spontaneous or bloody nipple discharge that arises from a single duct. The most common cause of nipple discharge is benign breast lesions, such as solitary intraductal papilloma and papillomatosis. Nevertheless, in rare cases, a malignant cause of nipple discharge can be found.Aims:To study the diagnostic value of ultrasonography, magnetic resonance imaging, and ductoscopy in patients with pathologic nipple discharge, compare their efficacy, and investigate the importance of magnetic resonance imaging in the diagnosis of intraductal pathologies.Study Design:Diagnostic accuracy study.Methods:Fifty patients with pathologic nipple discharge were evaluated by ultrasonography and magnetic resonance imaging. Of these, 44 ductoscopic investigations were made. The patients were classified according to magnetic resonance imaging, ultrasonography, and ductoscopy findings. A total of 25 patients, whose findings were reported as intraductal masses, underwent surgery oincluding endoscopic excision for two endoscopic excision. Findings were compared with the pathology results that were accepted as the gold standard in the description of the aetiology of nipple discharge. In addition, magnetic resonance imaging, ultrasonography and ductoscopy findings were analysed comparatively in patients who had no surgery.Results:Intraductal masses were reported in 26 patients, 20 of whom operated and established accurate diagnosis of 18 patients on magnetic resonance imaging. According to the ultrasonography, intraductal masses were identified in 22 patients, 17 of whom underwent surgery. Ultrasonography established accurate diagnoses in 15 patients. Intraductal mass was identified in 22 patients and ductoscopy established accurate diagnoses based on histopathologic results in 16 patients. The sensitivities of methods were 75% in ultrasonography, 90% in magnetic resonance imaging, and 94.6% in ductoscopy. The specificities were 66.7% in ultrasonography, 66.7% in magnetic resonance imaging, and 40% in ductoscopy. Intraductal papillomas were mostly observed as oval nodules with well-circumscribed smooth margins within dilated ducts and persistant in the dynamic analysis. Lesions that protruded into the lumen of the ducts, either solitary or multiple, were characteristic ductoscopy findings of our patients who were diagnosed as having papilloma/papillomatosis.Conclusion:Magnetic resonance imaging and ductoscopy had no statistical superiority over each other, however they were superior to ultrasonography in the diagnosis of pathologic nipple discharge. Magnetic resonance imaging may be highly sensitive for diagnosing nipple discharge with new techniques and sequences and a non-invasive method that more advantageous for showing ductal tree visualization and is able to detect completely obstructed intraductal lesions.

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“…Ultrasonografide duktal genişleme, solid ve kistik kitle olarak, galaktografide dolma defekti olarak görülürler. İntraduktal papillomatoziste magnetik rezonans (MR)'ın duktal karsinoma in situya (DKIS) gidişi göstermede önemli yeri vardır (5) . İntraduktal papillomatozis, atipik duktal hiperplazi veya DKIS öncüsü olabilir.…”

Section: Discussionunclassified