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