Microcalcifications in clinically normal breast: the value of high field, surface coil, Gd-DTPA-enhanced MRI

State-of-the-art screening mammography allows the detection of nonpalpable breast lesions in approximately 30 % of patients. The presence of clustered microcalcifications without evidence of solid tumors usually requires further investigations, mainly biopsy. A 1.5-T magnet with a single breast coil was used to evaluate 32 patients with indeterminate mammography suggestive of microcalcifications prior to surgery. Both spin-echo (SE) and gradient-echo (GE; 2D fast low-angle short [FLASH]) techniques were utilized before and after injection of 0.2 mmol/kg Gd-DTPA. Upon surgery tumor diameters ranged between 3 and 10 mm. Use of MRI demonstrated 87.5 % overall accuracy, 83.3 % sensitivity, and 92.9 % specificity. False-negative MRI results were in situ carcinomas less than 5 mm in size. All the correctly diagnosed carcinomas measured between 5 and 10 mm. Partial volume is probably the greatest limit of this technique and lesions equal to or smaller than 5 mm are only rarely detected. The GE and SE sequences demonstrated comparable results.