Fig. 12.1 Sonography.

Fig. 12.2a,b Digital mammography, MLO view.

Clinical Findings

Normal.

Fig. 12.3a–c Contrast-enhanced MR mammography.

Fig. 12.4 Contrast-enhanced MR mammography. Maximum intensity projection.

Ultrasound

The US image is of the lower inner quadrant of the left breast. It demonstrates a cyst compatible with the information provided by T2-weighted MRI. US BI-RADS left 2.

Mammography

The mammogram shows extremely dense parenchyma of both breasts, ACR type 4. Under these limiting conditions, no abnormalities were detectable. The macrocalcifications in the center of the left breast can be considered harmless and irrelevant. (BI-RADS right 1/left 1). PGMI: MLO view G (inframammary fold not clearly depicted).

MR Mammography

Subtraction images were obtained by subtracting the precontrast image from images derived from the second measurement after administration of contrast (approx. 3 minutes after introduction of contrast into peripheral veins). These early subtraction images show strong enhancement of all glandular tissue, meaning that It no further differentiation of circumscribed lesions was possible, However, a round enhancing area was observed in the inner region of the left breast (not shown on the slices reproduced here).

MRI Artifact Category: 2

MRI Density Type: 4

Preliminary Diagnosis

No remarkable findings from imaging.

Caution: It must be remembered that the sensitivity of x-ray mammography and MRI is limited by the circumstances of very dense parenchymal patterns (here ACR type 4, MRM density type 4).