Patterns of peripheral enhancement in breast masses: correlation of findings on contrast medium enhanced MRI with histologic features and tumor angiogenesis.
OBJECTIVE
Our goal was to review patterns of peripheral enhancement on contrast-enhanced MRI of the breast and to correlate radiologic findings with pathologic features.


METHODS
We reviewed the MR images of 124 consecutive women with breast lesions. Peripheral enhancement was identified in 35 (32 malignant, 3 benign) lesions. MRI findings were correlated with pathologic features including microvessel density and distribution determined histologically.


RESULTS
Early peripheral enhancement with centripetal progression was seen in invasive carcinomas with a high peripheral and a low central microvessel density, associated with fibrosis and/or necrosis (n = 18; 15 with central fibrosis, 2 with fibrosis and necrosis, and 1 with necrosis alone). Early peripheral enhancement with minimal or no change in enhancement was seen in both malignant (n = 10) and benign (n = 3) lesions. Delayed peripheral enhancement with centrifugal progression was seen in carcinomas that had an expansive growth pattern and a high marginal vessel density with or without a vascularized rim of connective tissue (n = 4).


CONCLUSIONS
Early peripheral enhancement with centripetal progression appears to be fairly specific for carcinomas, whereas early enhancement with minimal or no centripetal progression, although more common in malignant tumors, may be seen in some benign lesions as well.
Buadu
L D
LD
Department of Radiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Murakami
J
J
Murayama
S
S
Hashiguchi
N
N
Sakai
S
S
Toyoshima
S
S
Masuda
K
K
Kuroki
S
S
Ohno
S
S
D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000098:blood supply / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000098:blood supply / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000175:diagnosis / Q000000981:diagnostic imaging; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives*
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA