الفهرس 
AbstractOnly 14 pages are availabe for public view
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Abstract
Breast cancer is the most common malignant tumor among women.
The purpose of all diagnostic modalities in breast cancer is early detection and proper diagnosis, which has its major impact on further management and prognosis.
X-ray mammography is still considered the first examination tool in diagnosis of breast disease world wide.
The overlap in the mammographic appearance of benign and malignant lesions as well as dense breast tissue especially in young patients necessitates the presence of problem solving complementary studies.
US has been established as a complementary tool for mammography because of long experience with its use, accessibility, relatively low cost and the opportunity it affords for real time guidance of aspiration or needle biopsy. However, its operator dependence nature remains its main limitation.
The sensitivity of breast MRI for the detection of cancer is the greatest of all imaging techniques and when the findings of conventional imaging are inconclusive (i.e. BI-RADS 0), MRI can be used as a problem-solving modality, it is also better at identifying the true extent of cancer when multifocal disease or ductal carcinoma in situ is present. However its reported specificity is variable.
Recent developments in MR imaging technology have enabled the clinical application of DWI to the entire body, which has shown great promise for the detection and characterization of most tumor types. Through imaging of alterations in the microscopic motion of water molecules, DWI can yield novel quantitative and qualitative information reflecting cellular changes that can provide unique insights into tumor cellularity.
The current study evaluated the role of DWI as an adjunct to DCE-MRI in assessment of suspicious (BI-RADS 3 & 4) breast lesions diagnosed by mammography and US examination.
We conducted the study in Kasr El Aini hospital. The study included 50 patients with 50 breast lesions. Cases were referred from general surgery departments in Kasr El Aini hospital.
All patients were referred as (BIRADS 3or 4) by sonomammographic evaluation, for further DCE-MRI & DWI examination with classification of their findings according to Breast imaging reporting and Data System. The findings of each modality were correlated with histopathological results.
In our study the sensitivity of DCE-MRI, DWI for suspicious breast lesions(BIRADS 3& 4 )were 75.8 % and 82.75 respectively .Their specificity were 73.7 % and 78.9 %respectively.
So use of DWI as a diagnostic tool can increase the specificity of breast MR imaging and can reduce the number of false-positive results and associated unnecessary biopsies. In addition, DWI can be performed without significantly increasing examination time
It must be understood that DWI should be conjugated with DCE-MRI to avoid non visualization of small breast lesions, in this way it may improve the specificity of MRI for characterizing breast lesions.
Conclusion & recommendations
DWI proved to be of high specificity in characterization of mass and non masslesions soit can be added to DCE-MRI sequences to improve its specificity.
Also ,DWI can be used in pregnant females or cases with renal impairment to eliminate the hazards of contrast.