THE ROLE OF MRI SPECTROSCOPY AND ELASTOGRAPHY IN CHARACTERIZATION OF BREAST MASSES
Ghada Nabil Anwar Gawdat;
Abstract
SUMMARY
T
he breast forms a secondary sexual feature of females and source of nutrition for the neonate. Each breast is a rounded eminence lying within the superficial fascia extending between the 2nd and 6th ribs. The breast shape, size and internal architecture differ according to many factors like genetics, diet, race, parity and menopausal status of the individual. Considering the breast internal architecture, it is arranged into 15-20 lobes each is drained by single major lactiferous duct that opens into the nipple. The terminal duct lobular unit is the functional milk secretory component of the breast while the fat surrounding the parenchymal structures and the fibrotic framework of the breast constitute the dense stroma. The breasts are supplied by and drain into branches of the axillary, the internal thoracic, and some intercostal arteries and veins respectively. The lymphatic flow of the breast is of great clinical significance because metastatic dissemination occurs principally by the lymphatic routes. The lymph flows unidirectionally from superficial to deep plexus then drains from the nipple to the axillary and internal mammary chains.
Magnetic resonance imaging (MRI) of the breast provides a sectional image that can perfectly displays the internal architecture of the breast in full details and relation to the surrounding structures by assessing signal intensity. OnT1WI without fat saturation, adipose tissue is of high signal intensity and breast fibro-glandular elements appear relatively intermediate to dark. In T1WI with fat saturation, the signal intensity of fibro-glandular elements then becomes intermediate to bright, given that the fat appears dark. On T1WI, fat-saturated, gadolinium-enhanced; fat is dark and muscles are bright with enhancing breast tissue. On T2WI, the fat is bright, fibroglandular tissue is dark. The enhancement of breast tissue is influenced by the hormonal stimulation during the menstrual cycle and pregnancy. Moreover as patients advance in age, breast density decreases as fatty replacement to the glandular tissue occurs.
Breast masses are classified into benign and malignant types. The common benign tumours are Fibroadenoma and phyllodes tumour; both are composed of neoplastic stromal cells and epithelium-lined glands, however phyllodes tumour can turn to be malignant. Intraductal papilloma is also a benign neoplastic papillary growth usually seen within the principal lactiferous ducts or sinuses and Lipomas are benign tumours usually located in the subcutaneous fat composed of mature adipose tissue, both have a high risk of malignant transformation. Other benign tumours can be seen are the Hamartoma which is composed the components that make up normal breast tissue which makes it hard to be diagnosed and the Hemangioma which is rarely seen in the breast, contains only blood evidenced by FNAC Biopsys however it can turn to hemangiosarcoma.
T
he breast forms a secondary sexual feature of females and source of nutrition for the neonate. Each breast is a rounded eminence lying within the superficial fascia extending between the 2nd and 6th ribs. The breast shape, size and internal architecture differ according to many factors like genetics, diet, race, parity and menopausal status of the individual. Considering the breast internal architecture, it is arranged into 15-20 lobes each is drained by single major lactiferous duct that opens into the nipple. The terminal duct lobular unit is the functional milk secretory component of the breast while the fat surrounding the parenchymal structures and the fibrotic framework of the breast constitute the dense stroma. The breasts are supplied by and drain into branches of the axillary, the internal thoracic, and some intercostal arteries and veins respectively. The lymphatic flow of the breast is of great clinical significance because metastatic dissemination occurs principally by the lymphatic routes. The lymph flows unidirectionally from superficial to deep plexus then drains from the nipple to the axillary and internal mammary chains.
Magnetic resonance imaging (MRI) of the breast provides a sectional image that can perfectly displays the internal architecture of the breast in full details and relation to the surrounding structures by assessing signal intensity. OnT1WI without fat saturation, adipose tissue is of high signal intensity and breast fibro-glandular elements appear relatively intermediate to dark. In T1WI with fat saturation, the signal intensity of fibro-glandular elements then becomes intermediate to bright, given that the fat appears dark. On T1WI, fat-saturated, gadolinium-enhanced; fat is dark and muscles are bright with enhancing breast tissue. On T2WI, the fat is bright, fibroglandular tissue is dark. The enhancement of breast tissue is influenced by the hormonal stimulation during the menstrual cycle and pregnancy. Moreover as patients advance in age, breast density decreases as fatty replacement to the glandular tissue occurs.
Breast masses are classified into benign and malignant types. The common benign tumours are Fibroadenoma and phyllodes tumour; both are composed of neoplastic stromal cells and epithelium-lined glands, however phyllodes tumour can turn to be malignant. Intraductal papilloma is also a benign neoplastic papillary growth usually seen within the principal lactiferous ducts or sinuses and Lipomas are benign tumours usually located in the subcutaneous fat composed of mature adipose tissue, both have a high risk of malignant transformation. Other benign tumours can be seen are the Hamartoma which is composed the components that make up normal breast tissue which makes it hard to be diagnosed and the Hemangioma which is rarely seen in the breast, contains only blood evidenced by FNAC Biopsys however it can turn to hemangiosarcoma.
Other data
| Title | THE ROLE OF MRI SPECTROSCOPY AND ELASTOGRAPHY IN CHARACTERIZATION OF BREAST MASSES | Other Titles | دور الرنين المغناطيسي الطيفي والرنين المغناطيسي لقياس المرونه في وصف أورام الثدي | Authors | Ghada Nabil Anwar Gawdat | Issue Date | 2015 |
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