[Morphology and contrast enhancement of ductal carcinoma in situ in dynamic 1.0 T MR mammography].
OBJECTIVE
The detectability with magnetic resonance mammography (MR-M) of non-invasive ductal carcinoma in situ (DCIS), its morphology, and patterns of contrast enhancement were studied.


METHODS
A total of 849 MR-M examinations were performed in 741 patients using a dynamic, contrast-enhanced FLASH 3D sequence at 1.0 T. Surgical breast biopsies were obtained in 332 cases. Histological work-up confirmed 164 carcinomas, including 20 DCIS.


RESULTS
Of 20 DCIS, 14 were correctly diagnosed by MR-M on the basis of focal increase of signal intensity. In two cases (10%), no increase of signal intensity was observed. In another three cases (15%), multifocal enhancement lead to a false-negative diagnosis. In one case (5%), DCIS was a random finding in a patient diagnosed and treated for adjacent phylloides tumour. The sensitivity of MR-M was 70%. 4 (20%) of the DCIS did not show microcalcifications at conventional mammography and were only detected at MR-M. The sensitivity of conventional mammography also amounted to 70%. However, the combination of both imaging methods increased sensitivity to 90%.


CONCLUSIONS
Ductal carcinoma in situ is not reliably detectable by MR-mammography alone due to lack of a uniform pattern of enhancement.
Sittek
H
H
Institut für Radiologische Diagnostik, Klinikum Grosshadern, Ludwig-Maximilians-Universität, München.
Kessler
M
M
Heuck
A F
AF
Bredl
T
T
Perlet
C
C
Künzer
I
I
Lebeau
A
A
Untch
M
M
Reiser
M
M
D001706:Biopsy; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000473:pathology*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005069:Evaluation Studies as Topic; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography; D012680:Sensitivity and Specificity; D013997:Time Factors
D003287:Contrast Media; D019786:Gadolinium DTPA