MR-IMAGING OF MAMMOGRAPHICALLY DETECTED CLUSTERED MICRO CALCIFICATIONS - IS THERE ANY VALUE

PURPOSE: To assess the value of dynamic magnetic resonance (MR) imagin g in patients with mammographically detected suspicious microcalcifica tions. MATERIALS AND METHODS: Sixty-three patients (age range, 31-84 y ears; mean age, 56 years) with mammographically suspicious clustered m icrocalcifications underwent dynamic MR imaging of the breast before s urgical biopsy. MR imaging was performed with a 1.5-T unit and a two-d imensional fast low-angle shot sequence with a flip angle of 80 degree s. Thirty-two axial sections, 4 mm thick an without interval gaps, wer e acquired before and five times after administration of gadopentetate dimeglumine (dose, 0.1 mmol per kilogram of bodyweight). Histologic f indings were used as the standard of reference. Any effect of MR imagi ng on surgical management was noted. RESULTS: Biopsy findings verified five patients with T1 invasive carcinomas, 33 with ductal carcinomas in situ, 13 with proliferative fibrocystic disease, eight with nonprol iferative fibrocystic disease, and four with sclerosing adenosis. Cont rast material-enhanced dynamic MR imaging had a sensitivity of 45%, a specificity of 72%, and an overall accuracy of 56% in differentiating benign from malignant microcalcifications. All invasive tumors were de tected with MR imaging. In no case was surgical management altered by MR imaging findings. CONCLUSION: MR imaging of the breast is not relia ble in differentiation of benign from malignant breast disease in mamm ographically suspicious clustered microcalcifications and has no effec t on treatment.