الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
This study was conducted on thirty female patients operated previously for breast cancer and presenting with suspicious findings on ultrasound and/or mammography. Their age ranged between 21 years and 70 years with a mean age of 49.1 years.
The aim of the work was to evaluate the role of MRI with advanced techniques (namely dynamic contrast enhancement and diffusion) in differentiating between locoregional recurrent breast cancer and benign post-management related changes.
All patients were subjected to full history taking, thorough clinical examination, high resolution US, mammography in cases with breast conservative surgery, MRI imaging including conventional sequences, DWI and dynamic post-contrast assessment.
All MRI studies were obtained using a dedicated MRI machine (Philips, Achieva closed MRI machine) with magnets of intensity field 1.5 T and gradients 20 mT/m, equipped with bilateral dedicated breast coils.
Fat necrosis was found in 20 out of the examined 30 cases. By ultrasound they manifested as suspicious hypoechoic lesions and by mammography only two of them were seen as lucent focal lesions.
Conventional sequences (T1 and STIR) were of utmost importance in diagnosing fat necrosis; which manifested as focal T1 hyperintense lesion with total signal suppression in STIR. They showed no diffusion restriction and only peripheral thin rim of enhancement of type 1 curve.
Seven cases were recurrent malignant lesions, all demonstrated irregular T1 hypointense lesion of variable morphology, with diffusion restriction and positive enhancement after contrast administration with three cases demonstrating type 3 curve, three showing type 2 curve and one showing type 1 curve. Histopathological assessment confirmed the MRI findings in all seven cases.
Three cases were diagnosed as confluent scars. By MRI they showed irregular T1 hypointense lesion with no diffusion restriction or post-contrast enhancement.
MRI assessment including conventional methods, diffusion characteristics and post contrast assessment of lesions showed much better positive predictive value for MRI compared with conventional techniques (100% compared to 25%).