How is magnetic resonance mammography (breast MRI) sequences performed?

Updated: Feb 25, 2019
  • Author: Preeti Gupta, MD, FRCR; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

In general, repeated scans are performed through the breasts after contrast administration, with each one lasting between 1-2 minutes. All post-contrast imaging should be completed within 7-10 minutes, because the diffusion of contrast material into normal tissues limits diagnostic characterization after this time. This technique is called dynamic contrast-enhanced breast MRI (DCE-MRI).

To detect suspicious contrast enhancement, imaging times shorter than 10-60 seconds are generally unnecessary; as many as 5-10% of carcinomas enhance relatively slowly, reaching peak enhancement at 3 minutes or even longer.

Rapid serial, double-breast scanning with 2D multisection GRE imaging may be performed after the injection of contrast material, with or without image subtraction. This method is almost unchanged from the initial technique described by Kaiser and Zeitler. [42]

Slower, high-resolution, single-breast, fat-suppressed 3D imaging may be performed, with acquisitions in the first 3 minutes after the injection. High-resolution analysis of lesion architecture and enhancement is used. [41, 43] The use of 3–time-point, 3D, high-spatial-resolution acquisitions with these sequences has been described for additional low-temporal-resolution information.

A hybrid technique using a rapid serial 3D or 2D sequence for the first 2-3 minutes after the administration of contrast agent, followed by 2- to 3-minute high-resolution, fat-suppressed imaging in 1 plane, yields similar results. [44] Optionally, one may also add a rapid serial, dynamic, washout-phase acquisition after high-resolution imaging to increase diagnostic specificity for some invasive cancers.


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