Comparison of the contrast enhancement pattern in two different T1-weighted 3-D sequences in MR imaging of the breast

• Purpose: Can a complementary 3-D T1-weighted sequence (MPRAGE) facilitate the evaluation of contrast enhancement in patients with widespread and early contrast enhancement in our standard 3-D T1-weighted FLASH sequence? Material and Methods: Twenty patients with 21 breast lesions were examined with both FLASH and MPRAGE sequences. the MR examinations were reviewed independently by three radiologists. Results: In both the FLASH and MPRAGE sequences, 11 lesions were true-positive. In the FLASH sequence alone, 3 lesions were true-negative and 13 false-positive in comparison to the MPRAGE sequence alone in which 10 lesions were true-negative and 6 false-positive. Seven lesions that were false-positive in the FLASH sequence were true-negative in the MPRAGE sequence: this shows that MPRAGE has the potential to downgrade the false-positive findings found in the FLASH sequence. Conclusion: Due to its higher sensitivity, FLASH is the sequence of first choice at routine examination. However, when atypical increased enhancement was found, the addition of the MPRAGE sequence improved the specificity of the MR investigation.

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