Wk 1, Case 3 - Review
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So this patient's history of surgery in the
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right breast and, um, screening exam, right?
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So we see this commonly that if you have
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a screening MRI screening program in
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your institution, you might have patients
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coming in for high-risk sort of screening.
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And, um, you know, the first thing, uh, to
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mention here, this one, you always want to look,
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of course, at the, of everything, but, um, but
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things you'll notice in, for surgery, right?
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Um, you might see some distortion
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related to her surgery.
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You might see surgical clips.
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And I think both of those things are,
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um, easily evaluated on the, um, T1
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non-fat set, um, pre-contrast images.
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Um, so, you know, in this case here, right, we
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see the right breast looks a little bit smaller.
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Um, probably has some distortion here.
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It's a little bit hard to tell
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in this case, maybe right here.
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Oops.
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Um, I don't
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See the surgical clips too well here.
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I don't have any big ones.
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Of course, you could always
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verify on our mammogram.
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That'd be a lot easier.
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But, um, so that's stuff for surgical.
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So relatively subtle surgical findings
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here, but we know that history.
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Um, in the left breast,
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we've got two, uh, masses.
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Um, so we will look at her pre here and um,
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we can see some inherent, uh, T1 signal
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in those masses too, um, but what we want
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to look at are the post-contrast images
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here, and we can see one mass here, right
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has very smooth rim enhancement around
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that mass, and the other one is right here.
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Um, same sort of very smooth rim contrast.
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So think about that in distinction
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to the first case we had where
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we had rim enhancement, but it
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was very nodular, very irregular.
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That would be a much more suspicious finding.
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So, um, I think in this case, if we pull up
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the T2, we can see that those are T2 bright.
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This, this one, not as much, but I think
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we can be confident in calling those,
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um, cysts that have some inflammatory,
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inflammatory cysts that have some
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surrounding, um, smooth rim enhancement.
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Relatively straightforward case, but, um,
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but important to be able to confidently
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identify those, those inflammatory cysts.
Petra J Lewis, MBBS
Professor of Radiology and OBGYN
Dartmouth-Hitchcock Medical Center & Geisel School of Medicine at Dartmouth
Sheryl G. Jordan, MD
Professor, Department of Radiology
University of North Carolina School of Medicine
Ryan W. Woods, MD, MPH
Assistant Professor of Radiology
University of Wisconsin School of Medicine and Public Health
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