Avtor/Urednik		Francescutti, Giuliana E; Londero, Viviana; Berra, Ilaria; Del Frate, Chiara; Zuinani, Chiara; Bazzocchi, Massimo
Naslov		Breast MRI of ductal carcinoma in situ: is there MRI role?
Prevedeni naslov		MRI dojke pri duktalnem karcinomu in situ
Tip		članek
Vir		Radiol Oncol
Vol. in št.		Letnik 36, št. 4
Leto izdaje		2002
Obseg		str. 305-12
Jezik		eng
Abstrakt		Background. The purpose of this study is to report our personal experience of 22 cases of ductal carcinoma in situ (DCIS) studied with magnetic resonance imaging (MRI). Patients and methods. From September 1995 to December 2001, 22 women diagnosed with DCIS lesions underwent contrast enhanced MRI within 7 days after mammographic examination. Dynamic MRI was performed with a 1 T system, using a three dimensional fast low angle shot (FLASH) pulse sequence before and after contrast media administration. We evaluated the morphologic features of the enhancement, the enhancement rate and the signal time intensity curve. Pathology was obtained in all cases. Results. The results of histopatological examination included: 15 DCIS and 7 DCIS with associated mi- croinvasive component or microfoci of invasive ductal carcinoma (IDC). On MRl, 21 of 22 (95%) DCIS lesions showed contrast enhancement. Fourteen out of 15 pure DCIS lesions demonstrated respectively a low (3), undeterminate (5), and strong (6) enhancement. Morphologically, the enhancing lesion was focal in 7, segmental in 4, and with linear branching in 3 cases. Wash out was found in 4 cases, plateau curve in 8 and Type 1 curve in 2 cases. Multifocality was present in 5 cases. All DCIS with associated microinvasion demonstrated contrast enhancement: 1/7 cases showed a low en- hancement, 2/7 showed an indeterminate enhancement and 4/7 showed a strong enhancement. Morphologically, the enhancing lesion was focal in 3/9, segmental in 5 and with linear branching in 1 case. The wash out was demonstrated in 3/7 cases, plateau curve in 3 and Type 1 curve in lcase. Multifocality was present in 3 cases. Conclusions. In conclusion, the sensitivity of MRI for DCIS detection is lower than that achieved for in- vasive breast cancer, however, contrast-enhanced MRI can depict foci of DCIS that are maminographically occult. (Abstract truncated at 2000 characters).
Izvleček		Izhodišča. Namen te študije je bil proučiti naše izkušnje pri obravnavi 22 bolnic z duktalnim karcinomom in situ (DCIS), pri katerih smo opravili magnetno resonančno slikanje (MRI). Bolniki in metode. Med septembrom 1995 in decembrom 2001 smo pri 22 bolnicah z DCIS opravili s kontrastom ojačan MRI. Preiskavo smo naredili v 7 dneh po mamografiji. Dinamični MRI smo opravili s sistemom 1T in s tridimenzionalno (FLASH) pulzno sekvenco pred in po uporabi kontrastnega sredstva. Ocenjevali smo morfološke značilnosti, stopnjo ojačanja in krivuljo jakosti signala v času. Pri vseh primerih smo proces verificirali še histološko. Rezultati. Histopatološka preiskava je pokazala 15 DCIS in 7 DCIS s pridruženo mikroinvazivno komponento ali pridruženimi mikrootočki invazivnega duktalnega karcinoma. Od 22 lezij jih je 21 (95%) pokazalo kontrastno ojačanje; 14 od 15 lezij, ki so vsebovale samo DCIS, je pokazalo nizko ojačanje 3 lezij, nedoločeno 5 in močno 6. Morfološko so bile ojačane fokalne lezije v 7 od 14 primerov, segmentne v 4 od 14 in linearno razvejene v 3 od 14 primerov. Izplavljanje smo odkrili v 4 od 14 primerov, plato krivulje v 8 od 14 in krivuljo tipa I v 2 od 14 primerov. Pet primerov je bilo multifokalnih. Vsi DCIS s pridruženo mikroinvazijo so se kontrastno ojačali: 1 od 7 primerov je pokazal nizko, 2 od 7 nedoločeno in 4 od 7 močno ojačanje. Morfološko so bile ojačane fokalne lezije v 3 od 9 primerov, segmentne v 5 primerih in linearno razvejane v enem. Izplavljanje smo odkrili v 3 od 7 primerov, v 3 od 7 plato krivulje in krivuljo tipa I v 1 od 7 primerov. Trije primeri so bili multifokalni. Zaključki. Občutljivost MRI je pri DCIS nižja kakor pri invazivnem karcinomu dojk; lahko pa s kontrastom ojačana MRI prikaže mamografsko okultne otočke DCIS. MRI je dopolnilna preiskava za boljši prikaz velikosti tumorja in odkrivanje dodatnih zloveščih lezij.
Deskriptorji		BREAST NEOPLASMS CARCINOMA, INTRADUCTAL, NONINFILTRATING CARCINOMA IN SITU MAMMOGRAPHY MAGNETIC RESONANCE IMAGING