Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
44 Cards in this Set
- Front
- Back
|
What are the indications for breast MRI
5 |
evaluate extent of disease
axillary LAD with unknown primary one time screen of contralateral breast in pt with newly diagnosed breast cancer evaluate tx response high risk screening |
|
|
What are the top 6 examples of high risk pts that may require MRI screening
|
BRCA1/2 positive
untested first degree relative of BRCA Very strong family history previous chest radiation less than 30y strong family history of breast cancer personal history of breast cancer histologic LCIS/atypia very dense breast on mammography |
|
|
Out of the high risk group who is actually recommended to have mri screening
|
if there is a 20-25% increased lifetime risk of breast cancer
|
|
|
What people should therefore be considered for MRI screening
|
the top 4
BRCA1/2 positive untested first degree relative of BRCA Very strong family history of breast cancer chest irradiation less than 30y |
|
|
If there are multiple factors in a pts history how do you determine if a pt should be screened for MR screening
|
there are calculators on the internet
|
|
|
If breast MRI is done for screening should mammography be done also
|
yes, should alternate (at UcSF they alternat every 6 months)
|
|
|
What type of coil must be used for breast MRI
|
breast coil
|
|
|
What is the position of the patient in the MR scanner
|
prone
|
|
|
Why is prone position preffered
3 |
minimizes image degradation from breathing
breast stablilized or freely hanging down feet first entry minimizes claustrophobia |
|
|
What are the 3 sequences obtained for breast MRI
|
dynamic contrast enhanced T1
active fat suppression or subtraction T2 weighted images |
|
|
What is the dosage of gad given to the patient for breast MR
|
0.1mmol/kg
|
|
|
What should be included in breast MR report (first 3)
|
breast compostion
prescence of implants background enhancement |
|
|
What are the 4 categories of breast composition
|
almost entirely fat
scattered fibroglandular tissue heterogenous fibroglandular tissue mostly fibroglandular tissue |
|
|
What is the purpose of stating the breast composition
|
indicates that possibility that a breast lesion could be hidden.
|
|
|
What should be mentioned along with stating a women has implants
|
composition and # of lumen
|
|
|
What should be state about background enhancement
|
mild, moderate and marked
|
|
|
Why is stating the background enhancement important
|
affects the sensitivity for detecting abnormal enhancement
|
|
|
What are the 3 categories of abnormal enhancement
|
mass
non-mass like enhancment focus |
|
|
What is a focus
|
A lesion less than 5 mm and to small to further characterize
|
|
|
What are 4 descriptors that should be mentioned if there is a mass
|
size
location modifiers kinetics ex 12 x8mm round spiculated mass at 12 oclock in the right breast with wash out kinetics |
|
|
What are 4 descriptors that should be mentioned about a non-mass like enhancement
|
size
location morphology distribution large segmental area of clumped ductal enhancement in the LUO breast extending 5cm in greatest linear dimension |
|
|
What should be given at the end of the MR report
|
an overall summary and assessment category
|
|
|
What is the birads criteria
|
0 need additional imaging
1 negative 2 benign finding 3 probably benign 4 suspicious 5- highly suggestive 6 known malignancy |
|
|
What should be the birads category if the patient has a known malignancy but there is another suspicious feature
|
birads according to the other features
|
|
|
If there is a lesion adjacent to the pectoral muscle and then the pectoral muscle enhances on post contrast images does it mean muscle invasion
|
yes
|
|
|
Is persistent or increasing kinetics considered benign
|
yes
|
|
|
What type of cancer may show persistent kinetics
|
ductal carcinoma insitu
|
|
|
What is hormonal enhancement
|
hormone fluctuaton in premenopausal women which causes significant parenchymal enhancement worst during the second half of menstrual cycle
|
|
|
When is the best time to scan a women with MRI
|
day 3 to 14
|
|
|
What are the classic findings of ductal carcinoma insitu
|
clumped ductal enhancement extending towards the nipple
|
|
|
What is the MR findings of invasive ductal ca
|
spiculated mass
rapid contrast uptake rapid contrast washout increased T2 signal birads 5 |
|
|
What do you do if there is a spiculated enhancing mass that has persistent (increasing) kinetics
|
still gonna be birads 5 and should be resected
|
|
|
What is the kinetics of a fibroadenoma
|
persistent enhancement
|
|
|
What is the typical appearance of a fibroadenoma on MRI
|
very variable but if there is a well circumscribed lesion with persistent enhancement it may be considered a benign fibroadenoma
|
|
|
What is an artifact that can block enhancement of a lesion
|
water saturation
|
|
|
What type of image does water saturation occur and what does it look like
|
fat sat and it appears as areas of black
|
|
|
Where can you check to see if gad has been administered on a breast MR
|
the hear or aorta
|
|
|
What is the ddx of no contrast being in the image
|
contrast extravasation
injector malfunction incorrect agent (saline) loaded |
|
|
What is the difference of the protocol for implant evaluation and breast cancer
|
no gadolinium
|
|
|
What must be stated in the report for MR breast for implants
|
protocol does not evaluate for cancer
|
|
|
What is the cause of the linguine sign
|
silicone intracapsular implant rupture
|
|
|
What causes the liguine sign in an intracapsular silicone rupture
|
shell breaks and collapses
|
|
|
What happens to the silicone during a intracapsular rupture
|
silicone is contained by a fibrous capsule
|
|
|
What is an extracapsular rupture
|
silicone leaks outside of the fibrous capsule and into the parenchyma
|
