Signs in Mr-Mammography

About this book

Magnetic resonance mammography (MRM) is opening new avenues in the diagnosis of breast cancer. It has been known for over 20 years that MRM can accurately detect breast cancers larger than 3 millimeters. The problem in recent years has been an international debate concerning methods, techniques, and the interpretation of the myriad images. For years, the phrase “high sensitivity but low specificity� has been used like a mantra to characterize MRM. But results in recent decades suggest that we can greatly increase this limited specificity by extracting and analyzing all of the morphologic and kinetic signs contained in the 1000-plus images from an MRM examination. In this book we will explore the current known signs in MRM and illustrate them with examples so that, in the future, this information can be applied in the practical interpretation of MR mammograms.

Breast cancer is the most common cancer in women and the leading cause of death in women under age 50. It is hoped that when MRM is interpreted as described in this book, it can help to alleviate this major health problem by allowing breast cancers to be detected and treated at a earlier, curable stage.

Written for:

Radiologists; gynecologists; oncologists

Keywords:

• Breast Cancer
• Breast Imaging
• MR-Mammography
• MRI of the Breast

Table of contents

General Information
Sign 1 No enhancement
Sign 2 Slow wash-in
Sign 3 Medium wash-in
Sign 4 Fast wash-in
Sign 5 Plateau curve
Sign 6 Rising curve
Sign 7 Washout curve
Sign 8 Round shape
Sign 9 Oval shape
Sign 10 Lobulated shape
Sign 11 Irregular shape
Sign 12 Well-circumscribed margins
Sign 13 Irregular margins
Sign 14 Blooming sign
Sign 15 Constant sharpness sign
Sign 16 Homogeneous enhancement
Sign 17 Heterogeneous enhancement
Sign 18 Centrifugal enhancement
Sign 19 Centripetal enhancement
Sign 20 Dark internal septations
Sign 21 Enhancing internal septations
Sign 22 Segmental enhancement
Sign 23 Inflow enhancement
Sign 24 Regional unilateral enhancement
Sign 25 Multiple unilateral regional enhancement
Sign 26 Multiple bilateral regional enhancement
Sign 27 Diffuse unilateral enhancement
Sign 28 Diffuse bilateral enhancement
Sign 29 Stippled enhancement
Sign 30 Cobblestone enhancement
Sign 31 Reticular (dendritic) enhancement
Sign 32 Hypointensity on T2-weighted TSE images
Sign 33 Isointensity on T2-weighted TSE images
Sign 34 Hyperintensity on T2-weighted TSE images
Sign 35 Hook sign
Sign 36 Root sign
Sign 37 Pectoralis muscle invasion
Sign 38 Unilateral perifocal edema
Sign 39 Unilateral edema
Sign 40 Intact ligament sign
Sign 41 Disrupted ligament sign
Sign 42 Prepectoral unilateral edema
Sign 43 Intact nipple line
Sign 44 Disrupted nipple line
Sign 45 Unilateral precontrast high intraductal signal on T1-weighted images
Sign 46 Bilateral precontrast high intraductal signal on T1-weighted images
Sign 47 Nipple retraction
Sign 48 Asymmetric nipple enhancement
Sign 49 Diffuse unilateral skin thickening
Sign 50 Normal lymph nodes
Sign 51 Small round lymph nodes
Sign 52 Large lymph nodes
Sign 53 Pleural effusion < 7 mm
Sign 54 Pleural effusion > 7 mm
Sign 55 Eclipse sign
Sign 56 Signet ring sign
Sign 57 Shot-through sign
Sign 58 Unchanged enhancement curve
Sign 59 Changed enhancement curve
Sign 60 “Taller than wide” sign
Sign 61 “Wider than tall” sign
Sign 62 Punched-out sign
Sign 63 Bilateral symmetric edema
Sign 64 Skin retraction
Sign 65 Increased choline
Sign 66 ADC < 1.4 × 10–3 mm2/s
Sign 67 ADC > 1.4 × 10–3 mm2/s
Sign 68 Half-moon sign
Sign 69 Shrinking star sign
Sign 70 Clustered ring enhancement
Sign 71 Decrescendo sign
Sign 72 Crescendo sign
Sign 73 Staccato sign
Sign 74 Interrupted retroglandular fat layer
Sign 75 Continuous vessel sign
Sign 76 Antibiotic response sign
Sign 77 Antibiotic nonresponse sign
Sign 78 Vessel sign
Sign 79 Comet sign
Sign 80 Focal skin thickening
Sign 81 Permanent asymmetry of the breasts
Sign 82 Increasing asymmetry of the breasts
Sign 83 Precontrast signal too low
Sign 84 Precontrast signal too high
Sign 85 Maximum initial signal increase lower than the malignant threshold
Sign 86 Maximum initial signal increase within the malignant range
Sign 87 Maximum initial signal increase above the malignant threshold
Sign 88 Pseudocentric enhancement
Sign 89 Clip sign
Sign 90 Fat-water cyst
Sign 91 Unilateral hormone reversal sign
Sign 92 Bilateral hormone reversal sign
Sign 93 Hormone nonreversal sign
Sign 94 Intravascular contrast sign
Sign 95 Pectoralis pseudolesion
Sign 96 Tumor recovery sign
Sign 97 Incorrect shimming sign
Sign 98 Patchwork sign
Sign 99 Increased unilateral subcutaneous vascular density
Sign 100 Increased bilateral subcutaneous veins
Sign 101 Special STIR signal intensity pattern
Sign 102 Linguine sign
Sign 103 Pull-away sign
Sign 104 Keyhole sign
Sign 105 Extracapsular silicone sign
Sign 106 Pouch sign
Sign 107 Wavy line sign
Sign 108 Gel bleed sign
Sign 109 Focal ductal fluid sign
Sign 110 Two-chamber sign
Sign 111 Blood-water cyst
Sign 112 Blackberry sign
Sign 113 Tram lines
Sign 114 Fat separation sign
Sign 115 Bilateral pectoralis degeneration sign
Sign 116 Unilateral pectoralis atrophy sign
Sign 117 Intact retroglandular fat layer
Sign 118 STIR-selective perifocal edema
Sign 119 Border sign
Sign 120 Cross-talk sign
Sign 121 Unilateral subcutaneous rim enhancement
Sign 122 Intense peripheral rim on postcontrast STIR
Sign 123 Increased unilateral nipple enhancement
Sign 124 Small perifocal enhancement
Sign 125 Large perifocal enhancement
Sign 126 Dark heart sign
Sign 127 Unilateral subcutaneous edema
Sign 128 Stacked beads sign
Sign 129 Corona sign
Sign 130 Drapery sign
Sign 131 Crossing edema sign
Sign 132 Duct obstruction sign
Sign 133 Duct nonobstruction sign
Sign 134 Donut sign
Sign 135 Camouflage sign
Sign 136 Dissolving cancer sign
Sign 137 Melting candies sign
Sign 138 Constant candies sign
Sign 139 Bright T2w cancer
Sign 140 Enhancing pectoralis
Sign 141 Resolving edema sign
Sign 142 Recurrent border cancer
Sign 143 Bright round lymph nodes on T2-weighted TSE images
Sign 144 Normal cardiac and aortic enhancement
Sign 145 Increasing unilateral vessel sign
Sign 146 Increasing bilateral vessel sign
Sign 147 Lesion with high precontrast signal intensity
References