The aim of breast MRI is to obtain a reliable evaluation of any lesion within the breast. It is currently always used as an adjunct to the standard diagnostic procedures of the breast, i. Whereas the sensitivity of breast MRI is usually very high, specificity—as in all breast imaging modalities—depends on many factors such as reader expertise, use of adequate techniques and composition of the patient cohorts. Since breast MRI will always yield MR-only visible questionable lesions that require an MR-guided intervention for clarification, MRI should only be offered by institutions that can also offer a MRI-guided breast biopsy or that are in close contact with a site that can perform this type of biopsy for them. The overall aim of breast imaging can be summarized under several general headings.
Kopans DB. J Clin Oncol. Cancer yield of mammography, MR, and US in high-risk women: prospective multi-institution breast cancer screening study. Imaging studies Body enhancers for crossdressers first analyzed independently, then Mx was read in conjunction with US, followed by Mx combined with MRI, and finally, all three imaging modalities were read in Tombach breast mri. Sensitivity was defined as the number of breast cancers detected by a screening modality MRI or mammography, or the combination from the total number of breast cancers diagnosed during the study course. Number of screens needed Mr for additional mammography-only detected cancer was Tombach breast mri. Evaluating a combination of clinical, DCE-MRI, and diffusion parameters may improve breas ability to distinguish between benign and malignant lesions on breast MRI, thereby decreasing false-positive diagnoses and avoiding unnecessary biopsies. A second MRI, for the evaluation of the effect of chemotherapy on the tumor, should be performed when approximately half Tombaxh the Tpmbach of chemotherapy has been administered. It is currently always used as an adjunct to the standard diagnostic procedures of the breast, i. Diffusion-weighted imaging: effects of intravascular contrast agents on apparent diffusion coefficient measures of breast malignancies at 3 tesla.
Genitals big penus. Introduction
Since malignant lesions are typically T2 hyperintense, our preference Tombach breast mri to use MRI because it has superior diagnostic accuracy to CT [ 38 ]. The nonionic linear chelates Midgets nacked and gadoversetamide as well as the ionic linear chelate gadopentetate dimeglumine are classified in the Tombach breast mri of high-risk agents for NSF. MRI may then be used to exclude a ruptured prosthesis as the underlying cause of the complaints, and it may also aid explantation surgery as it Tombxch the presence and extent of silicone leakage better than any other imaging modality. MR-guided biopsy and ,ri localization It is clear that the increasing list of indications for the performance of breast MR leads to the detection of many lesions that are neither palpable nor visible on conventional imaging techniques. In this respect, it Tombach breast mri provide a definitive diagnosis or exclude the presence of a harmful abnormality. It is clear jri the increasing breazt of indications for the performance of breast MR leads to the detection of many lesions that are neither palpable nor visible on conventional imaging techniques. Taehan Kan Hakhoe Chi. Magnetic Soldering station with solder sucker imaging of the breast can be used bfeast pursue any of the above-mentioned goals. After the digital mammography, the same reader will perform Ultrasound of both breasts using the transmitter of MHertz Acuson Antares Siemens. If neoadjuvant chemotherapy is given to a patient, the first breast MRI should be performed before the start of chemotherapy.
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- Liver imaging in patients with a history of known or suspected malignancy is important because the liver is a common site of metastatic spread, especially tumours from the colon, lung, pancreas and stomach, and in patients with chronic liver disease who are at risk for developing hepatocellular carcinoma.
- The aim of breast MRI is to obtain a reliable evaluation of any lesion within the breast.
- Study record managers: refer to the Data Element Definitions if submitting registration or results information.
The aim of breast MRI is to obtain a reliable evaluation of any lesion within the breast. It is currently always used as an adjunct to the standard diagnostic procedures of the breast, i. Whereas the sensitivity of breast MRI is usually very high, specificity—as in all breast imaging modalities—depends on many factors such as reader expertise, use of adequate techniques and composition of the patient cohorts.
Since breast MRI will always yield MR-only visible questionable lesions that require an MR-guided intervention for clarification, MRI should only be offered by institutions that can also offer a MRI-guided breast biopsy or that are in close contact with a site that can perform this type of biopsy for them.
The overall aim of breast imaging can be summarized under several general headings. First, it is performed in symptomatic women to exclude breast cancer or other disease that requires immediate treatment. In this respect, it should provide a definitive diagnosis or exclude the presence of a harmful abnormality. Second, in patients with known malignancies, imaging helps in the preoperative staging and subsequent choice of appropriate therapy, either surgical or medical.
Third, in patients with known malignancies that are initially treated medically with neoadjuvant chemotherapy, imaging is helpful in the assessment of response to treatment and the evaluation of residual disease afterwards. Fourth, imaging is performed in asymptomatic women to detect breast cancer in its early stages, when it can be better treated, and in this respect imaging increases the prognosis and survival of breast cancer patients.
Last, imaging may be used to evaluate foreign bodies within the breast, such as the location of clips and markers or whether breast prostheses are intact. Magnetic resonance imaging of the breast can be used to pursue any of the above-mentioned goals. The aim of this paper is to provide guidelines for the performance and use of breast MRI, with respect to both the technical aspects of this procedure and the current indications.
MRI of the breast is a study that requires the administration of a gadolinium-containing contrast agent during the study [ 1 , 2 ]. Early studies have shown that breast MRI without contrast agent is not of diagnostic value [ 3 , 4 ].
The uptake of contrast medium in breast tissue in premenopausal women is also dependent on the phase of the menstrual cycle. It is essential to perform breast MRI in the correct phase of the cycle as enhancing normal breast tissue may otherwise complicate the interpretation of the study.
The optimal time in pre-menopausal women to perform a breast MRI is between the 5th and 12th day after the start of the menstrual cycle [ 5 — 7 ]. Placement of an intravenous cathether should be done before positioning the patient on the MR table. A long IV line avoids table and patient movement before the injection. The contrast agent should preferably be given by a power injector.
It is important to position the patient as comfortably as possible in order to avoid motion artifacts. A dedicated bilateral breast coil is mandatory for this investigation, and the patient should be placed in the prone position with both breasts hanging in the coil loops. The breasts may be supported to further reduce motion artifacts, but should not be compressed.
The position of the breast should be checked before the start of the examination, both breasts must be placed as deeply as possible in the coils with the nipples pointing down.
Virtually any MRI scanner can be used to perform contrast-enhanced breast MRI, as long as the system allows image acquisition at a sufficient spatial and temporal resolution see below. However, scanning protocols need to be adapted to the scanners used, also because the relaxivity of the most commonly used contrast agents decreases at higher field strengths [ 8 , 9 ]. Breast MRI at low and midfield strength 0. As this further decreases the signal-to-noise ratio SNR , this is not optimal.
In practice, most studies that employed low or midfield scanners did not obtain a sufficient spatial resolution [ 10 , 11 ]. An increasing field strength 1. A disadvantage is that, at higher field strengths e. Two-dimensional acquisitions are particularly sensitive to this effect and are therefore discouraged at 3 T [ 13 ]. The signal from the body coil can be used to evaluate the position and anatomy of the breasts. Furthermore, both axillae, the supraclavicular fossae, the chest wall and anterior mediastinum can be checked e.
However, this is not the purpose of a breast MRI, and this evaluation may also be omitted as there is no evidence of its diagnostic value. In the T2-weighted images water-containing lesions or edematous lesions have an intense signal, and in this sequence small cysts and myxoid fibroadenomas are very well identified.
In most cases cancer does not yield a high signal on T2-weighted images; thus, these sequences can be useful in the differentiation between benign and malignant lesions. However, as most of these lesions can also be identified on T1-weighted images, there is no evidence as yet of added value of T2-weighted sequences in breast MRI [ 14 , 15 ]. The most commonly used sequence in breast MRI is a T1-weighted, dynamic contrast enhanced acquisition. A T1-weighted 3D or 2D multi-slice spoiled gradient echo pulse sequence is obtained before contrast injection and then repeated as rapidly as possible for 5 to 7 min after a rapid intravenous bolus of a Gd-containing contrast agent.
A 3D pulse sequence offers a stronger T1 contrast and enables thinner slices than 2D; in turn, a 2D sequence suffers less from motion and pulsation artifacts. Both sequences can be performed with and without fat-suppresion [ 16 , 17 ]. The choice of the image orientation is important.
For bilateral dynamic breast MRI, axial or coronal orientations are most frequently used. Coronal imaging has advantages in that it can reduce heart pulsation artifacts, but it is more susceptible to respirational motion and also to flow artifacts because vessels tend to travel perpendicular to the slice-encoding direction.
Although bilateral sagittal imaging is possible today, it requires about double the number of slices required for the other orientations. As this hampers the spatio-temporal resolution, such an orientation is currently not feasible. The optimal dose of the contrast medium is unknown and also depends on the contrast agent used. In literature, applied doses range roughly from 0.
One study showed some benefit of 0. However, a more recent evaluation did not find any improvement in diagnostic accuracy using 0. Consequently, a dose of 0. Peak enhancement in the case of breast cancer occurs within the first 2 min after the injection of contrast medium.
Therefore, relatively short data acquisition times, in the order of 60— s per volume acquisition, are necessary. This allows sampling of the time course of signal enhancement after contrast injection, which is useful because the highly vascularized tumor of the breast shows a faster contrast uptake than the surrounding tissue.
More importantly, it enables a detailed analysis of morphologic details, because only in the very early post-contrast phase, the contrast between the cancer and the adjacent fibroglandular tissue is optimal. Long acquisition times will be associated with the risk of not resolving fine details of margins and internal architecture; this could have key importance for the differential diagnosis, and may even run the risk of missing cancers altogether because they are masked by adjacent breast tissue.
A dynamic sequence demands at least three time points to be measured, that is, one before the administration of contrast medium, one approximately 2 min later to capture the peak and one in the late phase to evaluate whether a lesion continues to enhance, shows a plateau or shows early wash-out of the contrast agent decrease of signal intensity [ 20 ]. It is thus recommended to perform at least two measurements after the contrast medium has been given, but the optimal number of repetitions is unknown.
However, the temporal resolution should not compromise the spatial resolution. It was shown that an increase in spatial resolution results in higher diagnostic confidence even when the temporal resolution is slightly sacrificed.
The final spatial resolution of the images depends on different factors, especially the size of the imaging volume, defined by the field of view FOV , the slice thickness and the acquisition matrix.
Therefore, the voxel size should be under 2. Preferably, the in-plane resolution should be substantially higher as morphologic features needed for lesion characterization, such as margin appearance, can only be evaluated when the resolution is sufficiently high.
Assessment of lesion morphology can be performed directly on the enhanced fat-suppressed images. However, as residual fat-signal hyperintense at T1-weighted images may cause difficulties in interpretation, the calculation of subtraction images from the pre- and post-contrast series is recommended [ 22 , 23 ].
Subtraction suppresses the signal from bright fat because fatty tissue hardly enhances. When subtraction is performed, fat suppression in the acquisition is not needed and is even discouraged, because in the large fields of view that are usually required for axial and coronal imaging, homogenous fat suppression is difficult to obtain. This can be problematic since fat and water resonance frequencies are relatively close at 1.
Moreover, fat-suppression increases the noise in the image and usually also compromises spatio-temoral resolution. Use of both detailed morphological information provided by high spatial resolution images and kinetic information curve type provided by at least two repetitions of the high spatial resolution sequence represents the latest trend in acquisition protocols and image interpretation to take into account the increasing importance of detailed morphological information without losing identification of washout enhancement curve types [ 24 ].
It also includes a lexicon that should be used for uniform reporting of the features seen on MRI [ 25 ]. Patients referred by their general practitioner or through a nationwide screening program to secondary care are told that there is a chance that they might have breast cancer.
In this situation imaging, with or without biopsy, should exclude the presence of a malignancy sufficiently. The sensitivity of breast MRI for the detection of cancer is the greatest of all imaging techniques [ 26 — 28 ], and when the findings of conventional imaging are inconclusive i.
In general, a negative breast MRI excludes malignancy. Only in case of mammographic microcalcifications, MRI is unable to exclude cancer sufficiently, and the decision to perform biopsy should be based on mammographic findings in this specific situation [ 29 ]. Tumor size of invasive carcinomas on MRI correspond in general well to pathologic sizes [ 32 , 33 ].
Inadequate size estimation or failure to detect additional foci of disease may thus result in positive resection margins after surgery or early recurrent disease. On MRI this may be seen as an area of contrast enhancement with a dendritic configuration close to the primary tumor.
Consequently, before large adjustments to the surgical management are effectuated, histological analysis of MR-detected additional foci should be performed. However, it is so far unclear whether breast MRI contributes to better control of the disease or survival of all patients with diagnosed breast cancer.
Only one study has evaluated such outcomes, and although MRI appears to reduce the incidence of local recurrence 1. The British COMICE trial is a large multicenter trial that randomizes patients between MRI and no-MRI and evaluates the quality of preoperative staging, the differences in outcome, differences in quality of life and cost-effectiveness [ 52 ]; the first results are expected in This study and similar ongoing studies may provide better evaluation of staging in the near future.
These lesions would probably have presented as metachronous contralateral carcinomas without MRI, as is also clear from the above-mentioned outcome study. Screening of the contralateral breast in patients with proven unilateral breast cancer is thus a valid indication for the performance of preoperative breast MRI.
In practice this means that preoperative MRI is recommended in all patients with histologically proven breast cancer, even though the indication for ipsilateral staging of the cancer is still under investigation. Especially in the case of dense breasts, MRI is recommended preoperatively. In the case of a carcinoma of unknown primary, metastases are diagnosed, but a primary tumor site cannot be identified.
These metastases may either present in the axillary lymph nodes, the supraclavicular lymph nodes, the bones, the liver, the brain or the lungs. MRI thus can subsequently be used to plan the most appropriate treatment as the size of these lesions on MRI is usually concordant with the size at pathology, thus MRI may prevent unnecessary mastectomies or assign patients with large tumors to neoadjuvant protocols.
Neoadjuvant chemotherapy is the administration of chemotherapy prior to surgical treatment of cancer. Its principal indication is the treatment of unresectable breast cancers, and its goal in this setting is to reduce the tumor to a size that allows resection. However, many studies have shown that the prognosis of breast cancer is equal when chemotherapy precedes or follows after surgery. Because there are some theoretical benefits in the neoadjuvant setting, and tumor response can be closely evaluated with the tumor in situ, neoadjuvant chemotherapy is also the standard of care in large T2 and T3 tumors.
MRI has been shown to be superior to evaluate tumor response to neoadjuvant chemotherapy compared to clinical examination, mammography or ultrasound and is thus the imaging investigation of choice. If neoadjuvant chemotherapy is given to a patient, the first breast MRI should be performed before the start of chemotherapy.
For bilateral dynamic breast MRI, axial or coronal orientations are most frequently used. Home Journals Why publish with us? Therefore, it is recommended to administer the lowest dose necessary for adequate imaging. The position of the breast should be checked before the start of the examination, both breasts must be placed as deeply as possible in the coils with the nipples pointing down. Rofo — [ PubMed ]. Neoadjuvant chemotherapy is the administration of chemotherapy prior to surgical treatment of cancer.
Tombach breast mri. Introduction
For patients at highest risk for NSF, the recommended dose should not be exceeded, and a sufficient period of time should be allowed for elimination of the drug before readministration.
In patients with chronically reduced renal function, acute kidney injury requiring dialysis has occurred with the use of GBCAs. In the presence of unbound gadolinium, fibroblast activity appears to be activated, eventually leading to systemic sclerosis and, potentially, to death. As the renal clearance of GBCAs may be impaired in the elderly, it is particularly important to screen patients aged 65 years and older for renal dysfunction.
There is no evidence to support the initiation of hemodialysis for the prevention or treatment of NSF in patients not already undergoing hemodialysis. Patients on hemodialysis can be scheduled to have the dialysis session shortly after the MRI examination. Patients on peritoneal dialysis are at extra risk due to the slow elimination of GBCA.
Multiple peritoneal dialysis should be encouraged to enhance the removal of the contrast molecules from the body. Acute kidney injury requiring dialysis has occurred in patients with chronically reduced renal function. Pretreatment can be given to patients with allergies before the MRI examination, and it consists of an administration of sedatives, followed by H1-antihistamines, H2- antihistamines, and cortisone. Limited published data on human exposure to other GBCAs during pregnancy did not show adverse effects in exposed neonates.
Inadvertent human exposure during the first trimester of pregnancy has not been associated with adverse effects in the fetus. Reports on use of GBCAs during the second or third trimester are not rare, underscoring the usefulness of these agents in diagnosing various conditions. No harm to the fetus has been documented in these circumstances. The doses in rats and rabbits were, respectively, 16 and 10 times the recommended human dose based on the body surface area.
Current radiology recommendations discourage the use of GBCAs during pregnancy because their safety for the fetus has not been proven. Yet, available evidence suggests it is unlikely that these compounds have an adverse effect on the developing fetus; therefore, their use should not be limited, particularly given the important clinical reasons for MRI examinations during pregnancy.
In conclusion, gadolinium use should be considered when the diagnostic study is important for the health of the mother. Limited case reports on use of GBCAs in nursing mothers reports that 0. The very small potential risk associated with absorption of the contrast medium may be considered insufficient to warrant stopping breast-feeding for 24 hours following the administration of GBCAs.
No dosage adjustment according to age is necessary in this population. For pediatric patients less than 2 years and more than 4 weeks old, after careful evaluation, the recommended dose should not exceed 0. Repeated administrations of GBCAs, close in time, are not recommended in pediatric patients, as well as their use for MRA in children under the age of 18 years. Figure 2 Contrast-enhanced T1 High-Res Isotropic Vol Excitation axial images for the characterization of renal mass in a patient with severe renal impairment.
The half-life of gadoteric acid is about 1. Following a 0. Gadoteric acid does not cross the intact BBB and, therefore, it does not enhance normal brain or lesions that have a normal BBB eg, cysts, mature postoperative scars. However, disruption of the BBB or abnormal vascularity allows the distribution of gadoteric acid in lesions such as neoplasms, abscesses, and infarcts.
Intravenously injected Gd-chelates are widely used to improve the efficacy of MRI in clinical practice and to identify, most notably, primary and metastatic brain neoplastic disease. Gd-chelates are extracellular, non-tissue-specific, non-protein-binding, water-soluble compounds prepared at a concentration of 0.
Figure 4 Axial A and B and sagittal C and D CE-T1-weighted images of the dorsolumbar spine in a patient affected by ependymoma of the intradural filum terminale. Gd-chelate agents are used for several new indications such as MRA and perfusion imaging. Advanced functional MRI techniques 3-T MRI scan , such as dynamic, contrast-enhanced, perfusion-weighted imaging PWI , utilize contrast agents to convey physiological information regarding the hemodynamics and neoangiogenic status of the lesion that is often complementary to anatomical information obtained through conventional imaging.
Together with diffusion-weighted imaging, it allows assessing the eligibility of acute ischemic stroke patients for revascularization. The goals of conventional brain tumor imaging are the sensitive detection and accurate depiction of disease in order to make a correct diagnosis and to provide, where appropriate, the tumor grade. In addition, conventional imaging can aid in the location of any adjacent critical structures before neurosurgery or radiotherapeutic intervention.
MRI of brain lesions also plays a vital role during the posttherapeutic or intervention phase in determining treatment response: early identification of the lack of treatment efficacy can facilitate selection of an alternative therapeutic approach, potentially improving patient outcome. The application of small amounts of cyclic GDCAs is recommended, especially in patients with impaired renal function. One of the common strategies for increasing MRI sensitivity in the detection of brain lesions is increasing the dose of the contrast agent.
While a standard dose of a GDCA is considered to be 0. However, higher doses of the contrast agent increased the cost of MRI and were associated with potentially more false-positive results.
Since then, there has been increasing concern for the development of NSF in renal-impaired patients when higher doses are used. Recent studies have shown a major advantage of macrocyclic gadolinium compounds as compared to linear gadolinium compounds in terms of stability, because the former group of agents is associated with a substantially lower amount of released, or free, gadolinium.
Although most gadolinium compounds including gadoteric acid have a gadolinium concentration of 0. In some reports, in vitro measurements of relaxivities at 1. On the basis of these relaxivity data, it is hypothesized that 1. Figure 5 Axial CE-T1 weighted image after iv administration of gadoteric acid in a patient with renal impairment and cerebral metastasis on right frontal lobe 3-T scan.
Gadoteric acid is also used in MRA for study of supraaortic vessels, and CMR is employed in the detection of chronic myocardial infarctions. MRA is a noninvasive and reliable tool for imaging blood vessels.
The combination of a gadolinium-bolus subtraction technique and fast gradient-echo sequence has been shown to provide more accurate angiograms of the aortoiliac arteries and arteries of the lower extremities.
Two studies, were performed at 1. Figure 6 Maximum intensity projection reconstructed image of contrast-enhanced magnetic resonance angiography of epiaortic vessels. Cardiac MRI is a well-established modality in the diagnosis of myocardial infarction because this disease can be difficult to diagnose clinically.
Moreover, biochemical evidence of infarction is present only for a limited time, and most myocardial infarctions are not associated with electrocardiography ECG Q-wave formation. MRI is of limited access and needs long acquisition times, preventing its use in the positive diagnosis of acute coronary syndromes without ST wave elevation non-ST segment elevation myocardial infarction, NSTEMI , which is particularly challenging.
Myocardial infarction is identified by late gadolinium enhancement, after iv administration of gadolinium chelates.
Late gadolinium-enhanced CMR images are obtained with a segmented inversion—recovery, fast, low-angle shot sequence on contiguous short-axis imaging planes 15 minutes after iv of 0. However, most studies use between 0. Cine CMR images can also be used to assess the contractility of the myocardium Figures 7 and 8. Figure 7 Late-enhancement phase-sensitivity inversion recovery short axis image of post infarction scar in the lateral-basal region of left ventricle.
Figure 8 Late-enhancement phase-sensitivity inversion recovery long axis image of postinfarction scar in lateral-basal region of left ventricle. Gadoteric acid is the only macrocyclic and ionic GBCA commercially available.
For all the pediatric patients, the recommended dose is consistent with the currently proposed pediatric dose in the US of 0. Figure 9 Axial and sagittal images contrast-enhanced T1 High-Res Isotropic Vol Excitation of pelvis in a female pediatric patient with bilateral sactosalpinx. Breast MRI is a well-consolidated diagnostic technique, with precise indications in the breast cancer field. The use of a paramagnetic contrast medium allows the study of breast mass vascularization and tumor neoangiogenesis.
This finding allows mass characterization not strictly based on morphological criteria but also on the qualitative and quantitative evaluation of its vascularization. Breast MRI is performed using a 1. DWI is performed using an axial single-shot echo-planar imaging sequence centered on the lesions.
The pictures obtained from the dynamic study are postprocessed using a dedicated appliance with the following procedures: automatic image subtraction, morphological qualitative analysis on enhancement foci, and quantitative and kinetic analysis of enhancement. Rounded regions of interest ROI are placed on the foci of enhancement identified on the subtracted images to measure the volumes on which the software generated the signal intensity time-curves. Typical maximum intensity projections MIPs obtained from postprocessing of subtracted images reveal not only the presence of enhanced lesions but also the angiographic vascular map of vessels of the whole breast.
Vascular mapping with CE-MRI is a new, intriguing topic with demonstrated implications for the diagnosis of invasive breast cancer. To date, no study of a large series of pure in situ cancers has been undertaken. Angiogenesis imaging may be useful for differentiating invasive from noninvasive cancers. Its possible usefulness for the evaluation of the effect of neoadjuvant chemotherapy on locally advanced cancers and for the stratification of risk of disease deserves careful evaluation in future studies.
Differentiation between arterial and venous breast vessels could be another area to be investigated. The use of high-relaxivity contrast agents such as gadobenate dimeglumine may provide real advantages for all of these future studies. The encouraging diagnostic yield of MRI in the detection and characterization of breast lesions must be weighed against its considerable costs.
The possible role as a screening tool for women at increased risk for breast cancer must be defined in context with other less expensive modalities. In the meantime, the high sensitivity of dynamic contrast-enhanced MR imaging DCE-MRI should be studied in those patients at high risk for mammographically occult breast cancer, and in patients with already proven cancer when multifocality needs to be excluded prior to breast conservation therapy.
Furthermore, young premenopausal women with a positive family history as well as patients with breast implants should be considered candidates for breast MRI Figures 10 and In the developed world, ovarian cancer is the fifth commonest cancer affecting women. In several other malignancies, including breast, prostate, and renal cancer, quantitative analysis of the dynamic contrast-enhanced sequence has proven useful.
In the study by Dilks et al, pelvic MRI was performed on a 1. An anti-peristaltic agent was administered by iv injection 20 mg hyoscine butylbromide, Buscopan; Boehringer Ingelheim, Germany. The following sequences were applied: axial T1-weighted spin-echo MRI from the renal hilum to the symphysis pubis; axial T2-weighted fast spin-echo FSE MRI of the pelvis or beyond if necessary to cover the larger adnexal masses; and sagittal T2-weighted FSE imaging from one femoral head to the other.
Unenhanced and enhanced fat-suppressed, spoiled, gradient-echo T1-weighted imaging was performed in the sagittal or axial plane. The total acquisition time for this sequence was 22—30 seconds. Multiparametric MRI has emerged as a safe, robust, and fairly reliable technique for the assessment of various pancreatic diseases. Major clinical indications for MR examinations of the pancreas include acute and chronic pancreatitis, analysis of cystic masses, assessment of lymph node size and infiltration, and staging of pancreatic carcinoma.
Dynamic images are collected before and after the bolus administration of gadoteric acid at a dose of 0. The agent was administered with an automated injector at a rate of 1. MRI examinations of the pancreas were performed at 1. Patients were imaged in the supine position. No bowel preparation was used before MR imaging, and the patients did not receive any antispasmodic agent.
The first acquisition was obtained 25—30 seconds after the administration of contrast material, and the second acquisition at 60 seconds.
The third acquisition was obtained seconds after injection, and the final acquisition equilibrium phase was performed 4 minutes after the beginning of administration of the contrast material.
All acquisitions were performed during suspended respiration at end expiration. Pancreatic CE-MRI makes it possible to obtain an excellent overview of the anatomy in the upper abdomen, but it also assists in determining loco-regional infiltration of pancreatic masses and lymph node involvement and thus justifies its integration into a standard protocol. In conclusion, gadoteric acid is a handy contrast medium for total body applications, in both adults and pediatric patients.
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After the digital mammography, the same reader will perform Ultrasound of both breasts using the transmitter of MHertz Acuson Antares Siemens. Eligibility Criteria. Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Inclusion Criteria: Women referred for routine breast cancer screening Exclusion Criteria: Disabled women eg, unable to stand Pregnant women Allergy to Gadolinium.
Contacts and Locations. Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its ClinicalTrials.
More Information. Swedish two-county trial: impact of mammographic screening on breast cancer mortality during 3 decades. Epub Jun Kopans DB.
Arguments against mammography screening continue to be based on faulty science. Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial. Abolishing mammography screening programs? A view from the Swiss Medical Board. N Engl J Med. Epub Apr Morris EA.
Diagnostic breast MR imaging: current status and future directions. Abbreviated breast magnetic resonance imaging MRI : first postcontrast subtracted images and maximum-intensity projection-a novel approach to breast cancer screening with MRI.
J Clin Oncol.
This website translates English to other languages using an automated tool. We cannot guarantee the accuracy of the translated text. MR imaging uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. The images can then be examined on a computer monitor or printed. By meeting their high standards, the American College of Radiology has accredited the S. MRI of the breast offers valuable information about many breast conditions that cannot be obtained by other imaging modalities, such as mammography or ultrasound.
Each exam produces hundreds of images of the breast, cross-sectional in all three directions side-to-side, top-to-bottom and front-to-back. MRI of the breast is not a replacement for mammography or ultrasound imaging but rather a supplemental tool for detecting and staging breast cancer and other breast abnormalities.
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