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Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Lesson
Pre-Course Activities
1 topic, 2 min.
Lesson
Introduction to Breast MRI
2 topics, 5 min.
Lesson
Indications and Protocol
5 topics, 33 min.
Lesson
MRI BI-RADS
3 topics, 14 min.
Lesson
Enhancing MRI Findings
8 topics, 28 min.
Lesson
Other Findings
4 topics, 20 min.
Lesson
Interpretation and Reporting
4 topics, 25 min.
Lesson
BI-RADS Case Review
22 topics, 1 hr. 17 min.
BI-RADS Assessment Categories – Overview
11 m.BI-RADS 1
5 m.BI-RADS 2 – Left Lumpectomy
4 m.BI-RADS 2 – Right Lumpectomy, Right Non-Enhancing Mass
2 m.BI-RADS 2 – Left Post Excisional Biopsy Change
3 m.BI-RADS 2 – Marked BPE, Stable
3 m.BI-RADS 2 – Bilateral Stable Findings
4 m.New focus of enhancement on a high risk patient (BI-RADS 4)
3 m.BI-RADS 3 – Changing Pattern of Background
2 m.BI-RADS 4 – Linear NME, Left Breast
4 m.BI-RADS 4 – Right Extensive DCIS, Left Dominant Focus
4 m.BI-RADS 4 – New Diagnosis Left Cancer, Focal NME left
3 m.BI-RADS 4 – New Diagnosis Right Breast Cancer, Nodes on Right
5 m.BI-RADS 4 – Left Axillary Node Metastasis, Evaluate for Breast Cancer
3 m.BI-RADS 5 – Suspicious Mass in Left Breast, Not Biopsied Yet
5 m.BI-RADS 5 – Left Breast Cancer, MRI Shows Right Cancer
5 m.BI-RADS 5 – New Diagnosis Right Cancer, Suspicious Masses in Right Breast
3 m.BI-RADS 5 – Right Inflammatory Cancer, Bilateral Nodes
4 m.BI-RADS 6 – Right Breast Cancer, No Other Findings
3 m.BI-RADS 6 – Left Breast Cancer, No Other Findings
2 m.BI-RADS 6 – Left Breast Cancer, Index Mass
4 m.BI-RADS 6 – Pre and Post Neoadjuvant Chemotherapy (NAC) for Left Breast Cancer
5 m.0:01
Next, we're going to look at a case of a
0:03
58-year-old woman with a history of left breast
0:05
cancer that was treated with mastectomy and
0:09
she has right breast pain and nipple discharge.
0:12
Her mammogram was negative, and in her
0:16
situation, her doctor ordered a breast MRI
0:20
for further evaluation.
0:23
So this is the patient's MRI.
0:25
We're really only looking at the right
0:27
breast because the left breast has had
0:30
a mastectomy with no reconstruction.
0:34
So coming from the top,
0:39
when we get into the central portion
0:40
of her breast, we start getting into
0:42
this clustered ring enhancement.
0:45
You can start seeing these rings of
0:49
enhancement with dark signal centrally.
0:54
Another pair here.
1:00
We get into the center of the breast.
1:01
You see three rings right there and
1:04
another one here, but she has this
1:08
whole area of non-mass enhancement,
1:11
but it has that clustered ring pattern.
1:14
When you stop and look at the individual
1:16
areas, there are multiple clustered rings
1:20
throughout that whole enhancing area.
1:26
Probably best seen right here in the middle,
1:29
but clustered ring enhancement.
1:32
So we did recommend biopsy for this,
1:35
and this ended up being a benign etiology.
1:41
She had ductal tissue with adjacent inflammatory
1:44
changes, and not sure if this was related to her
1:47
pain or discharge, but it was benign.
Clustered Ring NME – Benign
HIDEInteractive Transcript
0:01
Next, we're going to look at a case of a
0:03
58-year-old woman with a history of left breast
0:05
cancer that was treated with mastectomy and
0:09
she has right breast pain and nipple discharge.
0:12
Her mammogram was negative, and in her
0:16
situation, her doctor ordered a breast MRI
0:20
for further evaluation.
0:23
So this is the patient's MRI.
0:25
We're really only looking at the right
0:27
breast because the left breast has had
0:30
a mastectomy with no reconstruction.
0:34
So coming from the top,
0:39
when we get into the central portion
0:40
of her breast, we start getting into
0:42
this clustered ring enhancement.
0:45
You can start seeing these rings of
0:49
enhancement with dark signal centrally.
0:54
Another pair here.
1:00
We get into the center of the breast.
1:01
You see three rings right there and
1:04
another one here, but she has this
1:08
whole area of non-mass enhancement,
1:11
but it has that clustered ring pattern.
1:14
When you stop and look at the individual
1:16
areas, there are multiple clustered rings
1:20
throughout that whole enhancing area.
1:26
Probably best seen right here in the middle,
1:29
but clustered ring enhancement.
1:32
So we did recommend biopsy for this,
1:35
and this ended up being a benign etiology.
1:41
She had ductal tissue with adjacent inflammatory
1:44
changes, and not sure if this was related to her
1:47
pain or discharge, but it was benign.
Report
Description
Faculty
Lisa Ann Mullen, MD
Assistant Professor; Breast Imaging Fellowship Director
Johns Hopkins Medicine
Tags
Women's Health
Neoplastic
MRI
Breast
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