الفهرس | Only 14 pages are availabe for public view |
Abstract Radiodiagnosis Department, Faculty of Medicine, Ain Shams University *Corresponding Author: Amira Lotaif Abdullah Phone No.: (+2) 01097783092 E-mail: amiralotaiff@gmail.com Backgroud: Microcalcificaitons constitute up to 31% of lesions detected at screening mammography. Ductal carcinoma in situ (DCIS) often presents with microcalcificaitons on mammography. Of all mammographically detected DCIS lesions, up to 79% manifest with microcalcifications only. However, not all microcalficications are associated with in situ or malignant disease. Objectives: To evaluate diagnostic value of contrast enhanced digital mammography in breast microcalcificaations. Methods: A retrospective study of 30 patients having mammographic suspicious breast calcifications under BIRADS 4, 5 and 6 categories. A high-energy and a low-energy digital mammograms were obtained and then images were subtracted, isolating the iodine signal in the region of angiogenesis. 1.5 mg/kg of the contrast agent was injected by hand over a period of 1 minute at a rate of 3 mL per second, followed by a saline solution flush. Breast compression was applied to reduce the thickness of the breast and images obtained exactly 2 min after contrast administration. Image acquisitions: cranio-caudal and the medio-lateral oblique projections for the abnormal breast were obtained exactly 2 minutes after contrast injection followed by cranio-caudal and medio-lateral oblique projections of the normal breast. The lesions were analyzed by specialized radiologist for the presence, morphology, and pattern of enhancement. Finally, Correlation with histopathological findings was done. Results: The sensitivity of CEDM in detecting malignant pathology with contrast uptake was 96%. Compared to sensitivity of 86.7% in FFDM. There were lesions of IDC in (69.2%), lesion of DCIS in (11.5%), lesion of IDCS & IDC in (11.5%) and lesions of ILC in (3.8%). Enhancement was also observed in 3/4 (75%) of the benign lesions. Conclusion: Dual-energy contrast-enhanced digital mammography is a useful technique in the diagnosis of underlying disease in mammographically detected breast microcalcifications. |