Fig. 4
From: Can DWI-MRI be an alternative to DCE-MRI in the diagnosis of troublesome breast lesions?
A 49-year-old female patient presented with left breast lump. Mammography (A) showed left upper central focal asymmetry with mild architectural distortion and linear clustered calcification. Ultrasound (B) showed left 12 o’clock irregular hypoechoic lesion. Sonomammography revealed BIRADS 4. MRI axial images showed left upper central microlobulated lesion of intermediate T1 (C) and T2 signal intensity (D). MRI axial dynamic THRIVE sequence and subtraction image (E) showed left upper central microlobulated heterogeneously enhancing mass with a small nearby (anterior) suspected ring enhancing nodule. Time/signal intensity analysis of ROI (F) showed plateau curve pattern (type II) with SI % of 270%. Diffusion sequence b 850 (G) and post-processing ADC map (H) showed restricted diffusion with more evident anterior restricted nodule. ADC value for ROI was 0.9 × 10−3mm2/s. DCE-MRI and DWI-MRI revealed BIRADS 5 and suspicious findings. Pathology revealed invasive ductal carcinoma