34 Dr Ahmed Esawy imaging oral board of breast imaging part II (magnetic resonance mammography...

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Transcript of 34 Dr Ahmed Esawy imaging oral board of breast imaging part II (magnetic resonance mammography...

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The Art of Radiology

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Duct ectasia

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Fat containing lesionslymph nodes – 2nd look US

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Fat containing lesionsLipomas

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Fat containing lesionsHamartomas

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Intraductal papilloma

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Intraductal papillomacentral

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Central intraductal papillomaUS technique

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Ductography, filling defect

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Intraductal papillomacentral

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Complex cysts

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Papillary lesionsperipheral

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Papillary lesionsperipheral

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Papillary lesions

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Sebaceous cysts, Montgomery gland cysts, Epidermal inclusion cysts

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Sebaceous cyst, Epidermal inclusion cyst

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?

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Mondor’s disease: acute superficial thrombosis of

the breast veins.

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Hemangioma

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Neurofibroma

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Suggested approachbreast nodules

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Suggested approachbreast cysts

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Malignant Breast Lesions

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Ca are found at periphery of parenchyma

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Malignant lesions: A.Ducts1) DCIS:Poorly differentiated

Comedo Ca

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Malignant lesions: A.Ducts1) DCIS:Poorly differentiated Comedo Ca

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Malignant lesions: A.Ducts1) DCIS:Poorly differentiated Comedo Ca

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Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous

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Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous

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Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous

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Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous

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Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous

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Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous

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Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous

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Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous

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Malignant lesions: A.Ducts3) Colloid or Mucinous Carcinoma

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Malignant lesions: A.Ducts4) Medullary Ca

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Malignant lesions: A.Ducts4) Medullary Ca

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Malignant lesions: A.Ducts5) Inflammatory Ca

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Malignant lesions: B.Stromal Phylloide’s tumour

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Malignant lesions: B.Stromal Phylloide’s tumour

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Malignant lesions: B.Stromal Phylloide’s tumour

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Malignant lesions: C.Metastases

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Malignant lesions: C.Metastases

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Malignant lesions: C.Metastases

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Malignant lesions: C.Metastases

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Malignant lesions :

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Differential Diagnosis :

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56-year-old woman presented for a screening mammogram. She had a history of prior breast implants that were removed several years ago.

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Differential Diagnosis

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MRI BREASTMRM

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MRI BIRADS Lexicon

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Technique: MRI Sequences

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Technique: MRI Sequences

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Technique: MRI Sequences

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Technique: MRI Sequences

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MRI: Why Fat Suppression?

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Technique: MRI Sequences

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Assessment

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Dynamic Enhancement Patterns

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Benign Enhancement Pattern

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Malignant-like Enhancement

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MR Diffusion

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MR Diffusion

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Normal MRS of the Breast

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Normal MRS of the Breast

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Normal MRS of the Breast

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Normal MRS of the Breast

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Normal MRS of the Breast

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How to analyse a spectrum

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How to analyse a spectrum

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1H MRS Study of Breast Cancer

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1H MRS Study of Breast Cancer

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1H MRS Study of Breast Cancer

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1H MRS Study of Breast Cancer

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1H MRS Study of Breast Cancer

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1H MRS Study of Brain Cancer

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Response to chemotherapy

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Response to chemotherapy

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Axilla

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MRS MR DWI

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MRS breast Benefit

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Conclusion: MRS Limitations

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MR DUCTOGRAPHY

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MR guided Stereotactic Biopsy

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MR guided Biopsy

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Radiofrequency

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Case A : Lexicon

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Follow up chemotherapy

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Case A

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Case A

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Pre operative:

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Post Operative& Radiated

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Case B

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Pre operative evaluation

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Case C

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Pre operative

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Pre operative

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Follow up chemotherapy

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CASE D 32 yo with bx proven FA with new palpable lesion

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CASE D 32 yo with bx proven FA

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CASE 41 yo with palp nodule RUIQ

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CASE 41 yo with palp nodule RUIQ

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CASE 41 yo with palp nodule RUIQ

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CASE 41 yo with palp nodule RUIQ

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CAS E 41 yo with palp nodule RUIQ

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CASE H 55 year old - known carcinoma extent of disease

evaluation

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Known left breast carcinoma - scan ordered to evaluate extent of disease

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Pseudo-enhancement due to a subtraction artefact

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Pseudo-enhancement due to a subtraction artefact

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Pseudo-enhancement due to a subtraction artefact

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Invasive breast cancer with morphological findings better seen

on native images

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Rim of enhancement around a fat necrosis

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Non-mass-like enhancement

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Hypersignal on a T2 weighted sequence in invasive ductal carcinoma .

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Missed enhancement

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Misinterpreted enhancement

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BILATERAL BREAST CANCER

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BILATERAL BREAST CANCER

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MULTICENTRIC TUMOUR

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MULTICENTRIC TUMOUR

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MRI: Limitations

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Fibroadenomas: focal mass with round or oval shape and smooth margins, homogenous

internal architecture

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cysts

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cysts

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1 Dr Ahmed esawy imaging oral board of CNS part 1 imaging

1 Dr Ahmed esawy imaging oral board of CNS part 1 imaging

16-Dr Ahmed Esawy imaging oral board of sella hypothalamus imaging

16-Dr Ahmed Esawy imaging oral board of sella hypothalamus imaging

Imaging abdomen trauma spleenic trauma part 3 Dr Ahmed Esawy

Imaging abdomen trauma spleenic trauma part 3 Dr Ahmed Esawy

24 Dr Ahmed Esawy imaging oral board of chest imaging part II

24 Dr Ahmed Esawy imaging oral board of chest imaging part II

6 Dr Ahmed Esawy imaging oral board of CNS part vi imaging

6 Dr Ahmed Esawy imaging oral board of CNS part vi imaging

42-Dr Ahmed Esawy imaging oral board of splenic peritoneum imaging

42-Dr Ahmed Esawy imaging oral board of splenic peritoneum imaging

35-Dr Ahmed Esawy imaging oral board of breast imaging part III calcification ,magnetic resonance ductography

35-Dr Ahmed Esawy imaging oral board of breast imaging part III calcification ,magnetic resonance ductography

9 Dr Ahmed Esawy imaging oral board of skull imaging part I

9 Dr Ahmed Esawy imaging oral board of skull imaging part I

4 Dr Ahmed esawy imaging oral board of CNS BRAIN part iv imaging

4 Dr Ahmed esawy imaging oral board of CNS BRAIN part iv imaging

Full story fatty liver imaging Dr Ahmed Esawy

Full story fatty liver imaging Dr Ahmed Esawy

32 Dr Ahmed Esawy imaging oral board of cardio-thoracic imaging (rubens)

32 Dr Ahmed Esawy imaging oral board of cardio-thoracic imaging (rubens)

19 Dr Ahmed Esawy imaging oral board of neck masses imaging

19 Dr Ahmed Esawy imaging oral board of neck masses imaging

Imaging abdomen trauma renal part 5 Dr Ahmed Esawy

Imaging abdomen trauma renal part 5 Dr Ahmed Esawy

13 Dr Ahmed Esawy imaging oral board of spine imaging part III

13 Dr Ahmed Esawy imaging oral board of spine imaging part III

45 Dr Ahmed Esawy imaging oral board of bowel imaging part III(colon )

45 Dr Ahmed Esawy imaging oral board of bowel imaging part III(colon )

MRI imaging hypothalamus Dr Ahmed Esawy

MRI imaging hypothalamus Dr Ahmed Esawy

18 Dr Ahmed Esawy imaging oral board of larynx imaging

18 Dr Ahmed Esawy imaging oral board of larynx imaging

Full story pulomnary embolism imaging Dr Ahmed Esawy

Full story pulomnary embolism imaging Dr Ahmed Esawy

23 Dr Ahmed Esawy imaging oral board of chest imaging (Pulmonary nodules) part I

23 Dr Ahmed Esawy imaging oral board of chest imaging (Pulmonary nodules) part I

20 Dr Ahmed Esawy imaging oral board of salivary gland imaging

20 Dr Ahmed Esawy imaging oral board of salivary gland imaging