34 Dr Ahmed Esawy imaging oral board of breast imaging part II (magnetic resonance mammography...
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Transcript of 34 Dr Ahmed Esawy imaging oral board of breast imaging part II (magnetic resonance mammography...
The Art of Radiology
Duct ectasia
Fat containing lesionslymph nodes – 2nd look US
Fat containing lesionsLipomas
Fat containing lesionsHamartomas
Intraductal papilloma
Intraductal papillomacentral
Central intraductal papillomaUS technique
Ductography, filling defect
Intraductal papillomacentral
Complex cysts
Papillary lesionsperipheral
Papillary lesionsperipheral
Papillary lesions
Sebaceous cysts, Montgomery gland cysts, Epidermal inclusion cysts
Sebaceous cyst, Epidermal inclusion cyst
?
Mondor’s disease: acute superficial thrombosis of
the breast veins.
Hemangioma
Neurofibroma
Suggested approachbreast nodules
Suggested approachbreast cysts
Malignant Breast Lesions
Ca are found at periphery of parenchyma
Malignant lesions: A.Ducts1) DCIS:Poorly differentiated
Comedo Ca
Malignant lesions: A.Ducts1) DCIS:Poorly differentiated Comedo Ca
Malignant lesions: A.Ducts1) DCIS:Poorly differentiated Comedo Ca
Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous
Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous
Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous
Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous
Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous
Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous
Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous
Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous
Malignant lesions: A.Ducts3) Colloid or Mucinous Carcinoma
Malignant lesions: A.Ducts4) Medullary Ca
Malignant lesions: A.Ducts4) Medullary Ca
Malignant lesions: A.Ducts5) Inflammatory Ca
Malignant lesions: B.Stromal Phylloide’s tumour
Malignant lesions: B.Stromal Phylloide’s tumour
Malignant lesions: B.Stromal Phylloide’s tumour
Malignant lesions: C.Metastases
Malignant lesions: C.Metastases
Malignant lesions: C.Metastases
Malignant lesions: C.Metastases
Malignant lesions :
Differential Diagnosis :
56-year-old woman presented for a screening mammogram. She had a history of prior breast implants that were removed several years ago.
Differential Diagnosis
MRI BREASTMRM
MRI BIRADS Lexicon
Technique: MRI Sequences
Technique: MRI Sequences
Technique: MRI Sequences
Technique: MRI Sequences
MRI: Why Fat Suppression?
Technique: MRI Sequences
Assessment
Dynamic Enhancement Patterns
Benign Enhancement Pattern
Malignant-like Enhancement
MR Diffusion
MR Diffusion
Normal MRS of the Breast
Normal MRS of the Breast
Normal MRS of the Breast
Normal MRS of the Breast
Normal MRS of the Breast
How to analyse a spectrum
How to analyse a spectrum
1H MRS Study of Breast Cancer
1H MRS Study of Breast Cancer
1H MRS Study of Breast Cancer
1H MRS Study of Breast Cancer
1H MRS Study of Breast Cancer
1H MRS Study of Brain Cancer
Response to chemotherapy
Response to chemotherapy
Axilla
MRS MR DWI
MRS breast Benefit
Conclusion: MRS Limitations
MR DUCTOGRAPHY
MR guided Stereotactic Biopsy
MR guided Biopsy
Radiofrequency
Case A : Lexicon
Follow up chemotherapy
Case A
Case A
Pre operative:
Post Operative& Radiated
Case B
Pre operative evaluation
Case C
Pre operative
Pre operative
Follow up chemotherapy
CASE D 32 yo with bx proven FA with new palpable lesion
CASE D 32 yo with bx proven FA
CASE 41 yo with palp nodule RUIQ
CASE 41 yo with palp nodule RUIQ
CASE 41 yo with palp nodule RUIQ
CASE 41 yo with palp nodule RUIQ
CAS E 41 yo with palp nodule RUIQ
CASE H 55 year old - known carcinoma extent of disease
evaluation
Known left breast carcinoma - scan ordered to evaluate extent of disease
Pseudo-enhancement due to a subtraction artefact
Pseudo-enhancement due to a subtraction artefact
Pseudo-enhancement due to a subtraction artefact
Invasive breast cancer with morphological findings better seen
on native images
Rim of enhancement around a fat necrosis
Non-mass-like enhancement
Hypersignal on a T2 weighted sequence in invasive ductal carcinoma .
Missed enhancement
Misinterpreted enhancement
BILATERAL BREAST CANCER
BILATERAL BREAST CANCER
MULTICENTRIC TUMOUR
MULTICENTRIC TUMOUR
MRI: Limitations
Fibroadenomas: focal mass with round or oval shape and smooth margins, homogenous
internal architecture
cysts
cysts