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Patterns of Enhancement on Breast MR Images: Interpretation and Imaging Pitfalls¹

¹ From the Russell H. Morgan Department of Radiology and Radiological Sciences (K.J.M., R.O., M.A.J., D.A.B.) and Sidney Kimmel Cancer Center, Department of Oncology (M.A.J.), Johns Hopkins Medical Institutions, 600 N Wolfe St, BLA-B 179 RAD, Baltimore, MD 21287. Presented as an education exhibit at the 2005 RSNA Annual Meeting. Received March 15, 2006; revision requested April 12 and received May 23; accepted May 31. M.A.J. supported by grants NIH 1R01CA100184 and P50 CA103175. R.O. supported by grant 5R21CA095907. All authors have no financial relationships to disclose. Address correspondence to K.J.M. (e-mail: kmacura{at}jhmi.edu).

The role of dynamic contrast material–enhanced magnetic resonance (MR) imaging of the breast as an adjunct to the conventional techniques of mammography and ultrasonography has been established in numerous research studies. MR imaging improves the detection and characterization of primary and recurrent breast cancers and allows evaluation of the response to therapy. The breast imaging lexicon published by the American College of Radiology allows a standardized and consistent description of the morphologic and kinetic characteristics of breast lesions; however, there are many challenges in the interpretation of breast enhancement patterns and kinetics, and many imaging and interpretation pitfalls must be considered. New breast MR imaging techniques that are based on the use of molecular markers of malignancy may help improve lesion characterization. The margin characteristics of a lesion and the intensity of its enhancement at MR imaging 2 minutes or less after contrast material injection are currently considered the most important features for breast lesion diagnosis.

© RSNA, 2006