Breast carcinomas with strong high-signal intensity on T2-weighted MR images: pathological characteristics and differential diagnosis.
OBJECTIVE
To investigate the histopathological characteristics of breast carcinomas with strong high-signal intensity (SHi) on T2-weighted (T2W) MR images (T2-SHi), and discuss the differential diagnosis between T2-SHi breast carcinomas and T2-SHi fibroadenomas.


METHODS
Thirty of 480 breast carcinomas examined by MRI were defined as tumors with T2-SHi (defined as homogeneous higher signal intensity (SI) compared to surrounding normal breast tissue on fat-suppressed T2W imaging (T2WI). They included eight mucinous and 22 nonmucinous carcinomas. The histopathological characteristics of T2-SHi breast carcinomas, their signal-to-noise ratios (SNRs) on T2WI, contrast-enhancement patterns, and morphology were compared with those of 22 non-T2-SHi breast carcinomas and 19 T2-SHi fibroadenomas.


RESULTS
In nonmucinous carcinomas T2-SHi was attributable to a mixture of background matrix, a higher proportion of cells than stroma, abundant cytoplasm, edematous stroma, and hemorrhage. The significantly high SNR (mean = 75) and enhancing internal septations seen in mucinous carcinomas, and the washout phenomenon, irregular border, absence of internal septation, and rim enhancement seen in nonmucinous carcinomas provide useful information for differentiating these tumors from T2-SHi fibroadenomas.


CONCLUSIONS
A mixture of several histopathological characteristics was associated with T2-SHi breast carcinomas. The combined information from T2WI and contrast-enhanced (CE) imaging may help distinguish T2-SHi breast carcinomas from T2-SHi fibroadenomas.
Yuen
Sachiko
S
Division of Diagnostic Radiology, Shizuoka Cancer Center Hospital, Shizuoka, Japan. syuen@koto.kpu-m.ac.jp
Uematsu
Takayoshi
T
Kasami
Masako
M
Tanaka
Kumiko
K
Kimura
Kiyomi
K
Sanuki
Junichi
J
Uchida
Yoshihiro
Y
Furukawa
Hiroyoshi
H
D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis*; D002277:Carcinoma / Q000175:diagnosis*; D003287:Contrast Media / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005260:Female; D018226:Fibroadenoma / Q000175:diagnosis*; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation; D012189:Retrospective Studies; D012815:Signal Processing, Computer-Assisted
D003287:Contrast Media; D019786:Gadolinium DTPA