title: Simultaneous bilateral breast and high-resolution axillary MRI of patients with breast cancer: preliminary results.
abstract: OBJECTIVE
  The aims of this study were to develop a standardized one-step procedure for simultaneous high-resolution MRI of the axilla and bilateral breast MRI and to identify nodal features suggestive of metastatic involvement. SUBJECTS AND METHODS. We studied 16 women undergoing axillary lymph node dissection after combined bilateral breast MRI and high-resolution MRI of the axilla with a maximum in-plane resolution of 0.6 x 0.4 mm. MRI was performed using a standard double breast coil and a 15-cm round flexible surface coil adapted to the axilla. High-resolution axillary sequences, including inversion recovery T2- and spin-echo T1-weighted sequences, were performed before and after gadolinium chelates bolus injection. Axillary image analysis focused on nodal morphology including size, contour regularity, cortex and hilar appearance, signal intensity, and enhancement parameters. Axillary MRI findings were compared with the final pathogic results from axillary lymph node dissection in all patients. Patients were divided into groups according to the final pathologic axillary status. Differences in MRI lymph node features across the groups were tested using a t test for quantitative data and the chisquare test or Fisher's exact test for binary data.
  
  
  RESULTS
  The features of the axilla on high-resolution MRI that best discriminated between patients with positive pathologic findings and those with negative pathologic findings were the presence of nodes with irregular contours (p < 10(-4)), high signal intensity on T2 sequences (p < 10(-3)), marked gadolinium enhancement (p < 10(-3)), and round hila and abnormal cortexes (p < 0.05).
  
  
  CONCLUSIONS
  Breast tissue and axillary lymph nodes both can be analyzed on MRI in a one-step process using a bilateral breast coil combined with a surface coil. Morphologic features observed on high-resolution MRI of the axilla can improve the identification of metastatic nodes.
authors.affiliation: Service d'Imagerie Médicale, Hôpital Henri Mondor, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil 94010 Cedex, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Luciani
authors.forename: Thu Ha
authors.initials: TH
authors.lastname: Dao
authors.forename: Matthieu
authors.initials: M
authors.lastname: Lapeyre
authors.forename: Michael
authors.initials: M
authors.lastname: Schwarzinger
authors.forename: Cecile
authors.initials: C
authors.lastname: Debaecque
authors.forename: Laurent
authors.initials: L
authors.lastname: Lantieri
authors.forename: Geraldine
authors.initials: G
authors.lastname: Revelon
authors.forename: Mohamed
authors.initials: M
authors.lastname: Bouanane
authors.forename: Hicham
authors.initials: H
authors.lastname: Kobeiter
authors.forename: Alain
authors.initials: A
authors.lastname: Rahmouni
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies