الفهرس 
BREAST ANATOMYOnly 14 pages are availabe for public view
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Abstract
Breast MRI plays an increasingly important role after breast conservative therapy due to its high contrast resolution, lack of ionizing radiation and possibility of performing functional imaging sequences. DWI can now be used in breast imaging with an improved image quality and enables qualitative and quantitative assessment of tissue diffusivity
DWI is available on most commercial MR scanners and does not need secondary gadolinium use. It has a very short imaging time. The evaluation of the images obtained is quantitative and rather easy.
Follow-up of patients after conservative treatment includes a periodic clinical examination and mammography every 6 months during the first 2 years and every year thereafter. Inadequate treatment of the original cancer, including gross residual tumor, increases the likelihood of recurrence.
It is well known that the sensitivity of breast MRI is extremely high, and exceeds all other breast-imaging diagnostic tools.
• DWI proved to be of high specificity in mass lesions so:
- It can be added to DCE-MRI sequences to improve its specificity.
- It can be used alone combined with T2WI for cases in whom contrast agent could not be given.
• Both DWI & DCE-MRI are of limited specificity in non mass lesions as in mastitis & inflammatory carcinoma, so in these cases there is no need for MRI and biopsy is recommended.
• The combination of DWI to contrast-enhanced-MRI could show high diagnostic value in the evaluation of scar in patients operated for breast cancer. The combination of DWI and contrast-enhanced- MRI could reveal high diagnostic accuracy in the suspect of local recurrence of breast cancer.
• It could allow to avoid biopsy in positive patients and to send negative patients to follow-up, reserving biopsy in the cases with a clinical-radiological mismatch.
• In conclusion DWI improves the diagnostic accuracy of the DCE-MRI of the breast. It is a better method for detection than either T1- or T2-weighted imaging, but it is better to be performed in conjunction with contrast enhanced MRI (Park et al, 2007).
This preliminary study presents promising results. The combined protocol of DCE-MRI and DWI has the potential to increase the specificity and accuracy of breast MRI.