MRI contribution to the diagnosis of breast disease

Advantages and limitations: Magnetic resonance imaging of the breast is pro bably the most sensitive method for detecting or ruling out breast disease. It is however not as specific as expected. Technique: All examinations are performed with and without gadolinium intra venous administration, excepted in the case of silicone implant reconstruct ion mammoplasty. Dynamic contrast-enhanced MRI sequences are necessary with a permanent balance between temporal resolution, spatial resolution, and s ignal. MRI of the breast is not indicated as a routine examination in a scr eening program, neither to improve the specificity of infraclinic lesions, nor in simply dense breasts without any known risk factor or in circumscrib ed masses. Indications: MRI is best used to improved the sensitivity of mammography an d sonography in selected patients. The selected indications are evaluation of the volume and extension of breast lesions evaluation of the therapeutic response after chemotherapy, and detection or exclusion of the local recur rence in patients with breast conservation therapy. Perspectives: The future indications and perspectives of MRI include interv entionnal breast radiology (MRI-guided core biopsy), and thermocoagulation therapy. It may be interesting for the evaluation of patients with contrast enhanced MRI lesions with normal mammography and sonography, and also in w oman with a genetically defined high breast cancer risk.