Aims: To evaluate the role of dynamic contrast-enhanced magnetic resonance imaging (MRI) in the diagnosisof BI-RADS-5 type of microcalcifi cations of the breast, to compare the size of the microcalcifi cation lesions usingmammography (MG) and MRI, and to determine the value of MRI in surgery for microcalcifi cations. The study alsodetermines the morphology of microcalcifi cation lesions, assesses kinetic curves and compare MRI features of ductalcarcinoma in situ (DCIS) for diff erent histopathological grades. Methods: Our group consisted of 32 patients with mammographically detected BI-RADS 5 microcalcifi cations.The MRI was done in this group of women which was later followed by stereotactic vaccum-assisted biopsy (SVAB).Surgery was performed on all patients with a biopsy that resulted in a diagnosis of breast cancer or atypical ductalhyperplasia (ADH). Results: Of our group of 32 patients, there were 35 mammograhically detected microcalcifi cation lesions, 32 DCIS,one ADH and two benign fi ndings according to the fi nal histology.The microcalcifi cation lesions were larger using MRI than in MG in 10 women. We diagnosed DCIS multifocalityin 6 women and bilateral carcinoma in one woman. As with kinetic curve assessment, we found in 67 % of DCIS arapid rise, 27 % a moderate and in 6 % a slow initial rise. With the pattern of enhancement in the delayed phase, wefound in 30 % of DCIS a washout pattern, 67 % a plateau and in 3 % a persistent pattern. Noted diff erence betweenhigh and low grade DCIS was confi rmed. Conclusions: MRI sensitivity in the detection of DCIS was 94 % in our group of patients and was the sole evidencefor detection of multifocality and bilateral incidence of carcinoma. In 26 % of women the outcome of MRI was themost important for converting breast conserving surgery to mastectomy.

Department of Radiology Faculty of Medicine and Dentistry Palacky University Olomouc

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