الفهرس 
General anatomyOnly 14 pages are availabe for public view
 |  | from | 110 |  |  |
| | | from | 110 | | |
Abstract
Breast cancer is the most common form of cancer among women in the world and is the second leading cause of cancer deaths.
Although conventional mammography and ultrasonography of the breast are routinely used as imaging techniques for the detection of breast cancer worldwide, limitations in specificity and sensitivity remain problematic.
MR mammography gained a role in clarifying uncertain cases after mammography and/or ultrasonography. Nevertheless, some patients can not undergo MR examination due to the presence of MR contraindications or sever claustrophobic syndrome. Moreover, MRI shows excellent sensitivity but its limited specificity continues to be problematic.
Since helical MDCT became available, significant improvements in the technology have occurred, which improved the diagnostic accuracy of helical MDCT in detection and further evaluation of breast masses.
Helical CE-MDCT breast images give the surgeon accurate pre-operative information on the tumor distribution , size, extent, location and spatial relationships of breast tumors. Also, it is effective in detecting intraductal spread and multicentric lesions of breast cancer. Moreover, helical MDCT breast images and histologically mapped breast specimens can be easily and precisely correlated in details.
3D CE-CT images can display complex anatomic relationships and help the surgeon to perceive 3D spatial relationship of the carcinoma and breast tissue “at a glance”, as they might view at surgery, and avoid the need to mentally reconstruct the relationship from axial images. from data obtained from helical MDCT, the surgical plan for patient could be modified or totally changed.
Pre-operative CT lymphography-guided SLN mapping provides accurate SLN position with detailed lymphatic anatomy ,so, it can be useful for the direction of breast SLN biopsy and axillary dissection.
Moreover, CE-CT is valuable in the diagnosing and staging of the loco-regional breast cancer recurrences to the axilla, subclavian area and chest wall.
The main disadvantages of CE-CT are the irradiation of the breasts and the use of iodinated contrast agents. these remain the main obstacles for enrolling CE-CT as a routine scan program. However, helical MDCT offers an opportunity to obtain excellent images at a reduced radiation exposure.
Helical MDCT has many advantages over other modalities. With helical MDCT, the breast can be scanned faster and with thinner collimation than is possible with MRI examination. The patient is examined in supine position, which is more comfortable to the patient and it simulates the surgical position. Moreover, supine position allows easy approach for CT-guided breast biopsy. In addition, helical MDCT allows simultaneous evaluation of the axillary lymph nodes and lung metastasis.
CE-MDCT can be used as a complementary tool to mammography and ultrasonography in evaluation of patients with breast masses. There is no statistically significant difference in the overall accuracy between 3D- CT and 3D-MRI in the evaluation of breast cancer extent, which makes MDCT a good alternative to MRI in patients contraindicated to MRI examination.
Finally, helical CE-MDCT is now emerging as a promising modality for the detection and further evaluation of breast carcinoma.