DIAGNOSTIC VALUE OF MAGNETIC RESONANCE IMAGING WITH DYNAMIC CONTRASTING IN ASSESSING THE CONDITION OF BREAST SCARS AFTER INTERVENTIONS FOR BENIGN PATHOLOGY

Abstract

The lifetime probability of surgical interventions on mammary glands for benign pathology is approximately 4.8%, i.e. approximately they are performed in every 20th woman. At this, it is known that surgical interventions on organs containing an epithelial component significantly increase the risk of epithelial malignant tumors developing in them. The aim of the study was to assess the diagnostic value of magnetic resonance imaging (MRI) of the mammary glands with dynamic contrasting in identifying malignant transformation of breast scars after surgical interventions on it for benign pathology. Materials and methods. The study involved 63 patients aged 47.35±7.33 years who underwent breast surgery for benign pathology 1.5 years – 30 years before breast MRI was performed. Breast MRI with dynamic contrasting was performed using a Siemens Amira system (Germany) with a magnetic field intensity of 1.5 T. Study results. Morphological analysis: four types of morphological changes were identified during MRI in the area of previously performed intervention: 1) type 1 (thin-walled cavity / seroma; 5 out of 63; 7.94%; 0 cases of breast cancer); 2) type 2 (thin linear scar; 27 out of 63; 42.86%; 2 cases of breast cancer); 3) type 3 (mass lesion; 5 out of 63; 7.94%; 3 cases of breast cancer); 4) type 4 (fat necrosis; 26 out of 63; 41.30%; 1 case of breast cancer). Contrasting dynamics: 36 (57.14%) of 63 patients were noted to have contrast accumulation in the scar area. ACR type I of the kinetic curve (slow gradual accumulation of contrast) was observed in 10 out of 28 cases (35.71%) and in all cases corresponded to benign changes. ACR type II (rapid initial contrasting and plateau in the delayed phase) occurred in 10 out of 36 (27.78%) patients, of whom 2 had breast cancer. ACR type III (rapid initial contrasting and washout in the delayed phase) occurred in 13 of 36 (36.11%) patients, of whom 3 had breast cancer verified. Conclusions. The overall sensitivity of MRI with dynamic contrasting in detecting malignant transformation of scars in the mammary gland was 80%, specificity was 85.9%, the prognostic value of a positive result was 30.8%, the prognostic value of a negative result was 98.2%.