Peripheral washout sign on contrast-enhanced MR images of the breast.

Sherif, Hanan; Mahfouz, Ahmed; Oellinger, H.; Hadijuana, J; Blohmer, Jens-Uwe; Taupitz, Matthias; Félix, R.; Hamm, Bernd

doi:10.1148/radiology.205.1.9314987

Cited by 71 publications

(57 citation statements)

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“…In IBC, however, wash-out time curves prevail, mainly based on persistent neovascularisation. The wash-out phenomenon of invasive carcinomas is supposed to be caused by arteriovenous anastomoses with a consequent fast contrast medium outflow and the large number of capillaries with a high blood flow rate, resulting in a rapid transport of contrast agent from the intravascular to the interstitial compartment [14,15]. This mechanism also can explain the blooming sign [23] which was significantly more frequent in patients with IBC.…”

Section: Discussionmentioning

confidence: 99%

“…Vascular endothelial growth factor (VEGF) is up-regulated in malignant as well as inflammatory processes and is supposed to act as a key cytokine in breast oedema because of its influence on neovascularisation and increased permeability of these new capillaries [30,31,32]. Furthermore, blood vessels observed in carcinomas and inflammatory reactions typically show vasodilatation, which also results in oedema [15,30,31]. The distinct oedema is particularly responsible for the characteristic enlargement of the affected breast [8,20].…”

Section: Discussionmentioning

confidence: 99%

“…MRM has the highest currently reported sensitivity of all imaging modalities in breast cancer detection, approaching 99% with varying observer-dependent specificity levels [10,12,13,14]. Dynamic characteristics, such as plateau phenomenon and wash-out sign, have been proven in several publications to be an important criterion for the detection of invasive breast carcinomas [12,13,14,15]. Only a few reports particularly considered T2-weighted sequences to evaluate specific morphological criteria, such as tumour-associated oedema [16,17,18].…”

Section: Introductionmentioning

confidence: 99%

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Magnetic resonance imaging of inflammatory breast carcinoma and acute mastitis. A comparative study

et al. 2008

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The aim of this study was to evaluate the potential of magnetic resonance mammography (MRM) to distinguish inflammatory breast carcinomas (IBC) from acute mastitis (AM). This study compared MRM examinations of two selected groups of patients: 48 subjects with IBC and 42 patients with AM. No statistical differences were revealed between the two groups for morphology of masses and of non-mass-like enhancement, breast enlargement, diffuse skin thickening, abnormal nipple configuration, prominent vessels, and also for cutaneous/subcutaneous, perimamillar and diffuse oedema. However, initial and postinitial dynamic characteristics significantly differed between the two groups (p < 0.001). In IBC, more masses with a greater average size were detected (p < 0.05). The following morphological criteria were also observed more often in IBC (p < 0.05): T2-hypointensity of masses (77.5%/18.2%), blooming sign (62.5%/31.8%), infiltration of pectoralis major muscle (interruption of fat plane: 54.2%/16.7%; pathological enhancement: 33.3%/7.1%), perifocal (66.7%/33.3%), prepectoral (72.9%/31.0%) and intramuscular pectoral oedema (41.7%/7.1%). The main localisation of AM was subareolar, of IBC central or dorsal (p < 0.001). The discrimination between AM and IBC remains a diagnostic challenge because of overlapping imaging features. However, the combination of multiple dynamic and morphological MRM criteria seems to have the potential for a differential diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Magnetic resonance imaging of inflammatory breast carcinoma and acute mastitis. A comparative study

et al. 2008

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“…Type II (plateau curve) and type III (washout curve) are suggestive for malignancy, but the latter is highly predictive of malignant disease. Washout phenomenon alone has a positive predictive value of 87% [5], and peripheral washout is to 100% associated with breast cancer [47]. Both type-II and type-III curves have maximal uptake in the early postcontrast phase, but this qualitative criterion includes no subcategories according to the onset of contrast uptake.…”

Section: Mr Enhancement Kineticsmentioning

confidence: 99%

Invasive breast cancer: correlation of dynamic MR features with prognostic factors

et al. 2003

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The purpose of this exploratory study was to correlate kinetic and morphologic MR features with histologic prognostic factors in invasive breast cancer. Sixty-one women with invasive breast cancer underwent dynamic contrast-enhanced MR imaging at 1.5 T, using T1-weighted 3D fast low-angle shot technique. The MR characteristics were correlated with classical pathologic prognostic factors (tumor size, histologic type, grade and lymph node status) and immunohistochemically detected biomarkers [c-erbB-2, p53, Ki-67, and estrogen receptor (ER)]. Univariate and multivariate statistical analyses were performed. Presence of rim enhancement pattern, early maximal enhancement and washout phenomenon were independently associated with established predictors of poor prognosis (higher histologic grade, positive Ki-67, and negative ER status). Our results suggest that these MR signs are not only important in differentiating benign from malignant lesions, but may also be useful to noninvasively identify highly aggressive breast carcinomas.

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“…Delayed-phase scans were acquired at 4 min after the start of intravenous administration of the contrast material, whereas in Kitagawa's study, 19 the corresponding scans were obtained at 10 min after injection of the contrast material. Sherif's group 24 reported that a characteristic steep decline of the enhancement curve between 4 min and 10 min is observed at the periphery of the tumor in cases of breast carcinoma. Thus, rim enhancement detected in the early phase may remain in delayedphase scans acquired at 4 min after the injection of contrast material (Fig.…”

Section: Magnetic Resonance In Medical Sciencesmentioning

confidence: 99%

Dynamic High-Spatial-Resolution MR Imaging of Invasive Ductal Carcinoma: Influence of Histological Scirrhous Component on MR Descriptors

2006

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Purpose: The purpose of this study was to assess the relationship between the amount of scirrhous component in invasive ductal carcinoma and its MR characteristics.Materials and Methods: We retrospectively reviewed 71 consecutive patients with invasive ductal carcinoma smaller than 25 mm (average, 16.6 mm) in diameter. The scirrhous component was deˆned as invasive foci in small clusters of cancer cells showing desmoplasia. Invasive ductal carcinoma was subclassiˆed into 3 groups in accordance with the amount of the scirrhous component (scirrhous component degree; SCD): SCD I (scirrhous component less than 20z), SCD II (intermediate), and SCD III (more than 80z). Dynamic magnetic resonance (MR) imaging was performed using volumetric interpolated sequence. Prior to dynamic study, T 2 *-weightedˆrst-pass perfusion images were obtained before, during, and after bolus injection of 0.1 mmol Gd-DTPA W kg.Results: Twenty-eight lesions were classiˆed as SCD I, 14 as SCD II, and 29 as SCD III. Mass margin and signal intensity loss in the perfusion study were signiˆcantly diŠerent among the 3 SCD groups (Pº0.001). The kinetic patterns were signiˆcantly diŠerent among the 3 SCD groups (P＝0.04), and between SCD I W II and SCD III (P＝0.03). The presence of enhancing internal septations was signiˆcantly diŠerent between SCD I W II and SCD III carcinomas (P＝0.05). Central enhancement was only observed in SCD I carcinoma (4z; 3W 71).Conclusion: The histological predominance of the scirrhous component in invasive ductal carcinoma may be one explanation for the diŠerences in morphologic and kinetic patterns on MR imaging.

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Peripheral washout sign on contrast-enhanced MR images of the breast.

Abstract: Peripheral washout may be a reliable sign of malignancy on delayed contrast-enhanced MR images of the breast.

Cited by 71 publications

References 0 publications

Magnetic resonance imaging of inflammatory breast carcinoma and acute mastitis. A comparative study

Magnetic resonance imaging of inflammatory breast carcinoma and acute mastitis. A comparative study

Invasive breast cancer: correlation of dynamic MR features with prognostic factors

Dynamic High-Spatial-Resolution MR Imaging of Invasive Ductal Carcinoma: Influence of Histological Scirrhous Component on MR Descriptors

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