ENHANCEMENT PATTERNS ON MR MAMMOGRAPHY FOR ABNORMAL NIPPLE DISCHARGE

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  • 乳頭異常分泌症のＭＲマンモグラフィによるスクリーニング法

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Abstract

The purpose of this study was to evaluate the usefulness of enhancement patterns on MR mammography (MRM) in differentiating between benign and malignant lesions for abnormal nipple discharge (ND). Thirty-five women with ND underwent dynamic contrast enhanced MRM. Histological examination revealed 9 mastopathy, 11 intraductal papilloma, 7 ductal carcinoma in situ (DCIS) and 8 invasive carcinoma in 35 patients. For each lesion, we evaluated the time-intensity curve and two morphological features: distribution and lesion shape. The most reliable morphological pattern indicating benign lesions (mastopathy) was either no specific pattern or diffuse stippled distribution pattern, with a specificity of 10000 (26/26). The most reliable morphological pattern indicating intraductal papilloma was either subareolar clumped pattern, focal-clumped pattern or linear pattern with sensitivity and specificity of 100% (11/11) and 88% (21/24). The most reliable morphological pattern indicating malignancy was segmental distribution pattern with sensitivity and specificity of 93% (14/15) and 90% (18/20). The time-intensity curve was not valuable for screening to diagnose benign lesions in patients with ND. Only for the malignant cases, the time intensity curve helped to indicate the diagnosis with strong initial increase patterns. Morphological features, distribution and lesion shape, and time intensity curve may contribute in screening patients with ND before ductoscopy and biopsy.

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