Role Of Dynamic Contrast Enhanced MRI And Proton MR Spectroscopy In Evaluation Of Breast Masses

The adult breast lies between the second and sixth ribs in the vertical axis and between the sternal edge and the midaxillary line in the horizontal axis. Breast tissue also projects into the axilla as the axillary tail of Spence. The breast is comprised of three major structures: skin, subcutaneous tissue, and breast tissue, with the last comprising both parenchyma and stroma. The parenchyma is divided into 15 to 20 segments that converge at the nipple in a radial arrangement. The collecting ducts that drain each segment are 2 mm in diameter, with subareolar lactiferous sinuses of 5 to 8 mm in diameter. Approximately 10 major collecting milk ducts open at the nipple.With over a million new cases in the world each year, breast cancer is the most common malignancy in women and comprises 18% of all female cancers.Dynamic contrast-enhanced (DCE)-MRI refers to the acquisition of data before, during and after intravenous administration of contrast agent. It is an evolving tool for determining breast disease. It benefits from being non-invasive, allowing visualization of the extent of disease and its angiogenic properties.1H MR spectroscopy appears to have a bright future in the field of breast imaging. Its role in differentiating benign from malignant lesions and in improving the specificity of breast MR imaging may result in fewer breast biopsies. It assesses the presence of choline which occurs in malignant masses owing to increase membrane synthesis.