The adjacent vessel on dynamic contrast-enhanced breast MRI.
OBJECTIVE
The purpose of this study was to investigate whether an adjacent vessel leading to an enhancing lesion seen on subtraction images can help differentiate malignant from benign breast lesions and therefore increase the specificity of breast MRI.


METHODS
The study included 132 histologically verified lesions (71 malignant lesions, 10 pure carcinoma in situ, and 51 benign lesions) enhancing on dynamic breast MRI before biopsy. The lesions were evaluated by three radiologists in a double-blinded manner. The presence of an adjacent vessel was supposed if at least two observers voted positively.


RESULTS
Sixty-one (85.9%) of 71 malignant lesions, six (60%) of 10 carcinomas in situ, and 10 (19.6%) of 51 benign lesions were associated with an adjacent vessel, which differed significantly (p < 0.001) between benign and malignant lesions (the latter with and without including pure carcinoma in situ), leading to a positive predictive value of 85.9% (87% including pure carcinomas in situ), a negative predictive value of 80.4% (74.5% including pure carcinomas in situ), an accuracy of 83.2% (81.6% including pure carcinomas in situ), a sensitivity of 85.9% (82.7% including carcinomas in situ), and a specificity of 80.4% for this sign concerning malignancy.


CONCLUSIONS
The presence of an adjacent vessel seen on subtraction images promises to be a good marker for malignancy and can therefore help increase the specificity of breast MRI.
Fischer
Dorothee R
DR
Institute of Diagnostic and Interventional Radiology, University Hospital Jena, Jena 07747, Germany. dorothee.fischer@insel.ch
Malich
Ansgar
A
Wurdinger
Susanne
S
Boettcher
Joachim
J
Dietzel
Matthias
M
Kaiser
Werner A
WA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000098:blood supply* / Q000175:diagnosis*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies
D003287:Contrast Media