Ductal carcinoma in situ: Dynamic contrast-enhanced MRI features and correlation with pathologic findings

Objective: To explore dynamic contrast-enhancement MRI features of ductal carcinoma in situ (DCIS) of breast. Methods: Totally 44 patients with DCIS confirmed by pathology were retrospectively reviewed on the basis of breast imaging reporting and data system (BI-RADS). Results: (1)Among 44 DCIS lesions, 43 lesions enhanced. Eight lesions showed mass-like enhancement, while 35 lesions showed non-mass-like enhancement. Among non-mass-like lesions, 17 (17/35, 48.57%) segmentally enhanced, 6 (6/35, 17.14%) focally enhanced, and ductal distribution enhancement was observed in 4 lesions (4/35, 11.43%), and regional distribution of enhancement was found in 8 lesions (8/35, 22.86%). Mass-like enhancement was noticed in 8 lesions (8/43, 18.60%). (2)Time-signal intensity curve (TIC) was drawn for 42 lesions, TIC of type I, type II and type III was demonstrated in 5, 19, 18 lesions, respectively. (3)Among 30 lesions of pure DCIS, 13 were non-high-grade, 17 were high-grade, whereas 13 were DCIS microinvasion (DCIS-MI). There was significant difference of TIC type (P=0.0375), but no statistic difference for distribution of enhance pattern, internal enhancement between non-high-grade and high-grade (all P>0.05). No statistical differences was found between pure DCIS and DCIS-MI (all P>0.05). Conclusion: Non-mass-like enhancement, especially segmental cluster ring enhancement is the most characteristic feature of DCIS. Type II and III are the most common types of TIC. Significant relation exists between TIC type and different nuclear grade. Copyright © 2013 by the Press of Chinese Journal of Medical Imaging Technology.