0:01

Okay, so, for this next section,

0:03

I'm just going to show you some cases in each of the

0:06

BI-RADS categories.

0:08

So to start with BI-RADS 1 that's negative.

0:13

Our first case is a 35 year old woman for high-risk screening,

0:17

and she has a strong family history of breast cancer.

0:22

And here's our patient.

0:25

I'm just going to put up our maximum intensity

0:29

projection and our first subtracted series,

0:33

which is what we'd look at first,

0:34

and really not much going on here on the MIP.

0:38

A lot of blood vessels, some background parenchymal enhancement,

0:43

but not very much.

0:44

I'm just going to take a quick look here at the

0:49

first subtracted series.

0:53

And, you know,

0:54

some background parenchymal enhancement,

0:56

but not much happening.

0:58

When I pull in the T1,

1:04

You know, I'm evaluating this,

1:06

I know she has had no biopsy or surgery.

1:10

Her breast tissue is almost entirely fatty.

1:13

So we'll use that term for her amount of fibroglandular tissue.

1:18

Her parenchymal enhancement

1:21

her background parenchymal enhancement is pretty mild.

1:24

So we'll call that mild.

1:26

We did not see any enhancing findings.

1:30

We're going to review the other images as well,

1:35

which we can do relatively quickly.

1:37

This is the STIR image on the left, and then just bringing in

1:44

T1 pre and post contrast.

1:46

These are the source images and we can

1:52

scroll through these as well

1:54

from top to bottom.

1:55

Obviously, I would do this a little bit more slowly

1:59

in actual practice, but there's really nothing suspicious here.

2:05

and then we'll...

2:08

we do look at the second and third subtracted series as well,

2:13

and we really do look at each series carefully and then we go to...

2:19

Just to show you,

2:20

this is the second and third subtracted series,

2:24

and then we'll go to our kinetics map,

2:28

which I'm not able to show on this viewer, but basically

2:32

nothing colorized and no suspicious finding.

2:36

So this was a BI-RADS 1 case.

2:40

So really nothing suspicious

2:42

and we would recommend a screening

2:44

mammogram in a year and a screening

2:48

breast MRI in one year as well.

2:51

Our next patient is a 65 year old woman

2:54

with pain in the left breast.

2:57

So again, the pain in the left breast

2:58

would not be an indication for MRI.

3:01

But she does have a strong family history of breast cancer.

3:05

This says, three postmenopausal relatives,

3:07

so depending on,

3:09

you know, how old the relatives were and how, you know,

3:13

whether their first degree relatives,

3:15

might be relevant in her situation.

3:19

Okay, so again, we have our MIP here on the left. We can see

3:25

we've got some mild background parenchymal

3:27

enhancement and some blood vessels.

3:31

If we go to our first subtracted series, just to take a look at that.

3:38

It's really not a whole lot of enhancement.

3:40

Everything that's enhancing looks like a blood vessel.

3:43

From our T1-weighted images,

3:45

we can tell that the breast tissue has heterogeneous

3:49

fibroglandular tissue and really a mild background

3:54

parenchymal enhancement.

3:56

And as we scroll through, all we're seeing are enhancing vessels.

4:02

We go through all the rest of this series as well,

4:05

just showing the same thing. So this was BI-RADS 1,

4:09

really no abnormal enhancement.