Contrast-enhanced MR angiography of the breast: Evaluation of ipsilateral increased vascularity and adjacent vessel sign in the characterization of breast lesions

AJR Am J Roentgenol. 2010 Nov;195(5):1250-4. doi: 10.2214/AJR.10.4368.

Abstract

Objective: The purpose of this study was to investigate the role of evaluation of breast vascularity with contrast-enhanced MR angiography in the differentiation of malignant from benign lesions.

Materials and methods: Contrast-enhanced 3D MR angiograms of the breasts of 102 patients with unilateral and histopathologically confirmed breast lesions were evaluated retrospectively. All images were evaluated for both ipsilateral increased vascularity and adjacent vessel sign, and the values of these signs in the diagnosis of malignancy were assessed.

Results: Histopathologic analysis of 102 patients revealed 50 malignant and 52 benign results. In 31 of the 50 patients with breast cancer and in 11 of the 52 patients with benign lesions, ipsilateral breast vascularity was increased. The resulting sensitivity and specificity of ipsilateral increased vascularity were 62% and 79%. The adjacent vessel sign was present in 37 of the 50 patients with breast cancer and six of the 50 patients with benign lesions. The resulting sensitivity and specificity of the adjacent vessel sign were 74% and 89%. The overall accuracies of ipsilateral increased vascularity and the adjacent vessel sign were 71% and 81%.

Conclusion: Both ipsilateral increased vascularity and the adjacent vessel sign were found to be associated with breast cancer in a significant percentage of patients. The adjacent vessel sign is more practical and generally applicable. There is a borderline significance in favor of the higher accuracy of the adjacent vessel sign in comparison with ipsilateral increased vascularity (p = 0.043).

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Fine-Needle
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / pathology
  • Chi-Square Distribution
  • Contrast Media*
  • Diagnosis, Differential
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Magnetic Resonance Angiography / methods*
  • Middle Aged
  • Neovascularization, Pathologic / diagnosis*
  • Neovascularization, Pathologic / pathology
  • Organometallic Compounds*
  • Retrospective Studies
  • Statistics, Nonparametric

Substances

  • Contrast Media
  • Organometallic Compounds
  • gadobutrol