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Figure 1d. Benign features. (a, b) Contrast-enhanced T1-weighted fat-saturated gradient-echo (GRE) (repetition time msec/echo time msec, 20/4.5; flip angle, 30°) images from a 51-year-old woman show regional micronodular (<5 mm stippled or punctate) enhancement in fibrocystic breast tissue (a) and rimlike enhancement around a cyst (arrow in b) within a region of fibrocystic breast tissue. (c) T2-weighted (4000/90) fat-saturated image (same patient as in a and b) shows the cyst (arrow). Comparison of the contrast-enhanced images with the T2-weighted image is important to recognize the benign nature of these findings. (d) Contrast-enhanced T1-weighted GRE (20/4.5; flip angle, 30°) subtraction image from a 44-year-old woman shows an oval mass with smooth and lobular margins and enhancement with dark internal septa, typical of a fibroadenoma (arrow). (e) T2-weighted (4000/90) fat-saturated image (same patient as in d) shows increased signal intensity in the lesion (arrow) in comparison with that seen in d. Increased T2-weighted signal intensity is typical of a myxoid fibroadenoma in a woman of this age. In women older than 50 years, age-related sclerotic changes in fibroadenomas result in a greater prevalence of lesions with fibrotic low signal intensity, which reduces the diagnostic usefulness of the T2-weighted imaging characteristic.
