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BI-RADS 1

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Okay, so, for this next section,

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

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BI-RADS categories.

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

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

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and she has a strong family history of breast cancer.

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And here's our patient.

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I'm just going to put up our maximum intensity

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projection and our first subtracted series,

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which is what we'd look at first,

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and really not much going on here on the MIP.

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A lot of blood vessels, some background parenchymal enhancement,

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but not very much.

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

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first subtracted series.

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And, you know,

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some background parenchymal enhancement,

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but not much happening.

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When I pull in the T1,

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You know, I'm evaluating this,

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I know she has had no biopsy or surgery.

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Her breast tissue is almost entirely fatty.

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

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Her parenchymal enhancement

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her background parenchymal enhancement is pretty mild.

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So we'll call that mild.

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We did not see any enhancing findings.

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

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which we can do relatively quickly.

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

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T1 pre and post contrast.

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These are the source images and we can

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scroll through these as well

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from top to bottom.

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Obviously, I would do this a little bit more slowly

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

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and then we'll...

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

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

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Just to show you,

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this is the second and third subtracted series,

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and then we'll go to our kinetics map,

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

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nothing colorized and no suspicious finding.

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So this was a BI-RADS 1 case.

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So really nothing suspicious

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and we would recommend a screening

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mammogram in a year and a screening

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breast MRI in one year as well.

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Our next patient is a 65 year old woman

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with pain in the left breast.

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So again, the pain in the left breast

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would not be an indication for MRI.

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

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This says, three postmenopausal relatives,

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so depending on,

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

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whether their first degree relatives,

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might be relevant in her situation.

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

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we've got some mild background parenchymal

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enhancement and some blood vessels.

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

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It's really not a whole lot of enhancement.

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Everything that's enhancing looks like a blood vessel.

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From our T1-weighted images,

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we can tell that the breast tissue has heterogeneous

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fibroglandular tissue and really a mild background

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parenchymal enhancement.

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

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

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

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really no abnormal enhancement.

Report

Description

Faculty

Lisa Ann Mullen, MD

Assistant Professor; Breast Imaging Fellowship Director

Johns Hopkins Medicine

Tags

Women's Health

MRI

Breast

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