Investigative Magnetic Resonance Imaging

Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회)
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Clinical Applications of Breast MRI

유방자기공명영상의 임상 적용

  • Cho, Nariya (Department of Radiology, Seoul National University Hospital) ;
  • Moon, Woo-Kyung (Department of Radiology, Seoul National University Hospital)
  • 조나리야 (서울대학교병원 영상의학과) ;
  • 문우경 (서울대학교병원 영상의학과)
  • Published : 2009.06.30
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Abstract

Breast MRI is a cutting-edge technology in the diagnosis and intervention of breast abnormalities. Over the last decade, breast MRI has evolved from a research field to a clinical field. Radiologists should understand the indications, how to obtain adequate images, and how to interpret and report their findings. Breast MRI is now used in the differentiation of benign from malignant mass, preoperative staging of breast cancer patients, assessment of tumor response to neoadjuvant chemotherapy, and evaluation of women with breast implants. It can also be used as a supplemental screening modality for high-risk women. Qualified radiologists and adequate MRI technique are crucial for the success of these purposes. This review is focused on the indication, standardized use of lexicon and categorization of breast MRI.

유방 MRI는 유방 질환의 진단과 치료 분야에 최첨단 기법으로서 지난 10년 동안 유방 MRI는 연구 분야에서 임상 분야로 진화해 왔다. 따라서, 유방 MRI의 적응증과 적절한 영상을 얻는 방법, 소견을 해석하고 보고하는 법에 대한 이해가 필요하다. 유방 MRI는 양성과 악성 종괴의 감별, 유방암 환자의 수술 전 병기 결정, 수술전 항암요법에 대한 종양의 반응 평가, 유방 성형 여성의 평가 등에 사용되고 있다. 또한 유방암 고위험군 여성에서 선별 보조 검사로서 사용될 수 있다. 이러한 목적을 성공적으로 이루기 위해서는 적절한 MRI기법과 다른 유방 영상 소견과 연관 지어 해석할 수 있는 영상의학과 의사가 중요하다. 본 소고에서는 유방 MRI의 적응증, 표준화된 용어와 카테고리의 사용에 중점을 두어 기술하고자 한다.

Keywords

References

  1. Schneider BP, Miller KD.Angiogenesis of breast cancer. J Clin Oncol 2005;23:1782-1790. https://doi.org/10.1200/JCO.2005.12.017
  2. Heywang SH, Wolf A, Pruss E, Hilbertz T, Eiermann W, Permanetter W. MR imaging of the breast with Gd-DTPA: use and limitations. Radiology. 1989;171:95-103. https://doi.org/10.1148/radiology.171.1.2648479
  3. Kaiser WA, Zeitler E. MR imaging of the breast: fast imaging sequences with and without Gd-DTPA. Preliminary observations. Radiology 1989;170:681-686. https://doi.org/10.1148/radiology.170.3.2916021
  4. Harms SE, Flamig DP, Hesley KL, et al. MR imaging of the breast with rotating delivery of excitation off resonance: clinical experience with pathologic correlation. Radiology 1993;187:493-501. https://doi.org/10.1148/radiology.187.2.8475297
  5. ACR Practice Guideline for the performance of magnetic resonance imaging of the breast 2004 p517-519.
  6. Saslow D, Boetes C, Burke W, et al. Americal cancer society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin 2007;57:75-89. https://doi.org/10.3322/canjclin.57.2.75
  7. Kuhl CK, Schild HH, Morakkabati N. Dynamic bilateral contrast- enhanced MR imaging of the breast: trade-off between spatial and temporal resolution. Radiology 2005;236:789-800. https://doi.org/10.1148/radiol.2363040811
  8. Kuhl C. The current status of breast MR imaging. Radiology 2007;244:356-378. https://doi.org/10.1148/radiol.2442051620
  9. Bazzocchi M, Zuiani C, Panizza P, et al. Contrast-enhanced breast MRI in patients with suspicious microcalcifications on mammography: results of a multicenter trial. AJR Am J Roentgenol 2006;186:1723-1732. https://doi.org/10.2214/AJR.04.1898
  10. Morris EA. The normal breast. In Morris EA, Liberman L. Breast MRI: diagnosis and intervention. New York: Springer, 2005:23-44.
  11. American College of Radiology. Breast imaging reporting and data system (BI-RADS). 3rd edition. Reston (VA): American College of Radiology; 2003.
  12. Morris EA. Breast MR imaging lexicon updated. Magn Reson Imaging Clin N Am 2006;14:293-303. https://doi.org/10.1016/j.mric.2006.07.001
  13. Liberman L, Mason G, Morris EA, Dershaw DD. Does size matter- Positive predictive value of MRI-detected breast lesions as a function of lesion size. AJR Am J Roentgenol. 2006;186:426-430. https://doi.org/10.2214/AJR.04.1707
  14. Brown J, Smith RC, Lee CH. Incidental Enhancing Lesions Found on MR Imaging of the Breast. AJR Am J Roentgenol 2001; 176: 1249-1254. https://doi.org/10.2214/ajr.176.5.1761249
  15. Nunes LW, Schnall ME, Siegelman ES, et al. Diagnostic performance characteristics of architectural features revealed by high spatial-resolution MR imaging of the breast. AJR Am J Roentgenol. 1997;169:409-415. https://doi.org/10.2214/ajr.169.2.9242744
  16. Nunes LW, Schnall MD, Orel SG. Update of Breast MR Imaging architectural interpretation model. Radiology 2001;219:484-494. https://doi.org/10.1148/radiology.219.2.r01ma44484
  17. Liberman L, Morris EA, Dershaw DD, et al. Ductal enhancement on MR imaging of the breast. AJR Am J Roentgenol 2003; 181:519-525. https://doi.org/10.2214/ajr.181.2.1810519
  18. Kuhl CK, Mielcareck P, Klaschik S, et al. Dynamic breast MR imaging: are signal intensity time course data useful for differential diagnosis of enhancing lesions- Radiology 1999;211:101-110. https://doi.org/10.1148/radiology.211.1.r99ap38101
  19. Lee CH. Problem solving MR imaging of the breast. Radiol Clin N Am 2004;42:919-934. https://doi.org/10.1016/j.rcl.2004.05.001
  20. Orel SG. Enhancing lesions: what do I do- In. Syllabus of Society of Breast Imaging 2007. p39-43.
  21. LaTrenta LR, Menell JH, Morris EA, Abramson AF, Dershaw DD, Liberman L. Breast lesions detected with MR Imaging: utility and histopathologic importance of identification with US. Radiology 2003;227:856-861. https://doi.org/10.1148/radiol.2273012210
  22. Hefler L, Casselman J, Amaya B, et al. Follow-up of breast lesions detected by MRI not biopsied due to absent enhancement of contrast medium. Eur Radiol 2003;13:344-346.