MRI of fat necrosis of the breast: The "black hole" sign at short tau inversion recovery

Rubina M. Trimboli, Luca A. Carbonaro, Francesco Cartia, Giovanni Di Leo, Francesco Sardanelli

Research output: Contribution to journalArticle

Abstract

Objective: To describe MRI features of fat necrosis of the breast. Materials and methods: Twenty-five lesions in 16 patients were retrospectively analyzed. MRI was performed due to equivocal findings at conventional imaging after surgical treatment of cancer (n = 14) or during anticoagulant therapy (n = 1), after focal mastitis treated with ductal resection (n = 1). In the 15 patients with previous surgery MRI was performed after a median interval of 24 months, using short tau inversion recovery (STIR) and contrast-enhanced dynamic T1-weighted sequences. Signal-to-noise ratio (SNR) inside the lesion and surrounding healthy fat was calculated on both STIR and unenhanced T1-weighted images. Maximal lesion diameter was measured on STIR images. All lesions had final clinical and imaging assessment in favor of fat necrosis and negative clinical and imaging follow-up (21-40 months; median 24 months). Results: At STIR sequence, fat necrosis appeared as a "black hole", being markedly hypointense (median SNR = 29) compared with surrounding fat (median SNR = 95) (P <0.001), while no significant difference was found at unenhanced T1-weighted sequence. No significant correlation with time from treatment was found. Of 25 lesions, 15 showed ring enhancement, with continuous increase (n = 10), plateau (n = 2), or wash-out curve (n = 3). The 11 enhancing lesions in the 8 patients with previous radiation therapy showed an initial enhancement higher than that of the 4 enhancing lesions in the 2 patients who did not, although the difference was not significant (P = 0.104). Conclusion: Fat necrosis of the breast exhibits a "black hole" sign on STIR images, allowing for an easier diagnosis in clinical practice.

Original languageEnglish
JournalEuropean Journal of Radiology
Volume81
Issue number4
DOIs
Publication statusPublished - Apr 2012

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Fat Necrosis
Signal-To-Noise Ratio
Breast
Fats
Sequence Inversion
Mastitis
Anticoagulants
Radiotherapy
Therapeutics
Neoplasms

Keywords

  • Breast
  • Fat necrosis
  • Magnetic resonance imaging (MRI)
  • Short tau inversion recovery (STIR)

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

MRI of fat necrosis of the breast : The "black hole" sign at short tau inversion recovery. / Trimboli, Rubina M.; Carbonaro, Luca A.; Cartia, Francesco; Di Leo, Giovanni; Sardanelli, Francesco.

In: European Journal of Radiology, Vol. 81, No. 4, 04.2012.

Research output: Contribution to journalArticle

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abstract = "Objective: To describe MRI features of fat necrosis of the breast. Materials and methods: Twenty-five lesions in 16 patients were retrospectively analyzed. MRI was performed due to equivocal findings at conventional imaging after surgical treatment of cancer (n = 14) or during anticoagulant therapy (n = 1), after focal mastitis treated with ductal resection (n = 1). In the 15 patients with previous surgery MRI was performed after a median interval of 24 months, using short tau inversion recovery (STIR) and contrast-enhanced dynamic T1-weighted sequences. Signal-to-noise ratio (SNR) inside the lesion and surrounding healthy fat was calculated on both STIR and unenhanced T1-weighted images. Maximal lesion diameter was measured on STIR images. All lesions had final clinical and imaging assessment in favor of fat necrosis and negative clinical and imaging follow-up (21-40 months; median 24 months). Results: At STIR sequence, fat necrosis appeared as a {"}black hole{"}, being markedly hypointense (median SNR = 29) compared with surrounding fat (median SNR = 95) (P <0.001), while no significant difference was found at unenhanced T1-weighted sequence. No significant correlation with time from treatment was found. Of 25 lesions, 15 showed ring enhancement, with continuous increase (n = 10), plateau (n = 2), or wash-out curve (n = 3). The 11 enhancing lesions in the 8 patients with previous radiation therapy showed an initial enhancement higher than that of the 4 enhancing lesions in the 2 patients who did not, although the difference was not significant (P = 0.104). Conclusion: Fat necrosis of the breast exhibits a {"}black hole{"} sign on STIR images, allowing for an easier diagnosis in clinical practice.",
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AB - Objective: To describe MRI features of fat necrosis of the breast. Materials and methods: Twenty-five lesions in 16 patients were retrospectively analyzed. MRI was performed due to equivocal findings at conventional imaging after surgical treatment of cancer (n = 14) or during anticoagulant therapy (n = 1), after focal mastitis treated with ductal resection (n = 1). In the 15 patients with previous surgery MRI was performed after a median interval of 24 months, using short tau inversion recovery (STIR) and contrast-enhanced dynamic T1-weighted sequences. Signal-to-noise ratio (SNR) inside the lesion and surrounding healthy fat was calculated on both STIR and unenhanced T1-weighted images. Maximal lesion diameter was measured on STIR images. All lesions had final clinical and imaging assessment in favor of fat necrosis and negative clinical and imaging follow-up (21-40 months; median 24 months). Results: At STIR sequence, fat necrosis appeared as a "black hole", being markedly hypointense (median SNR = 29) compared with surrounding fat (median SNR = 95) (P <0.001), while no significant difference was found at unenhanced T1-weighted sequence. No significant correlation with time from treatment was found. Of 25 lesions, 15 showed ring enhancement, with continuous increase (n = 10), plateau (n = 2), or wash-out curve (n = 3). The 11 enhancing lesions in the 8 patients with previous radiation therapy showed an initial enhancement higher than that of the 4 enhancing lesions in the 2 patients who did not, although the difference was not significant (P = 0.104). Conclusion: Fat necrosis of the breast exhibits a "black hole" sign on STIR images, allowing for an easier diagnosis in clinical practice.

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KW - Short tau inversion recovery (STIR)

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