Case Report

FINDINGS OF EXTENSIVE COSTAL AND STERNAL METASTASIS OF A PATIENT WITH BREAST CARCINOMA BY DYNAMIC, DIFFUSION WEIGHTED AND THREE DIMENSIONAL BREAST MAGNETIC RESONANCE IMAGING

  • Şebnem Örgüç
  • Işıl Başara
  • Feray Aras

Received Date: 29.10.2010 Accepted Date: 09.03.2011 Eur J Breast Health 2012;8(1):48-53

Breast magnetic resonance imaging (MRI) is used in local staging of breast carcinoma with high sensitivity and accuracy. During this technique bony structures of the thorax such as sternum and anterior ribs are also evaluated. Direct graphy and computed tomography are not diagnostic in the patients with costal metastasis which have medullary bone infiltration without pathological fracture. Dynamic breast MRI can determine bone metastasis without cortical destruction. Especially multiplanary maximum intensity projection (MIP) images which are obtained from postcontrast substructed images are helpful in determining bone metastasis. Coronal MIP images can show infiltration of bony costas. Chondromateus costas are usually preserved. Bone syntigraphy is accepted as the gold standard for determining bone metastasis, however the spatial resolution of MRI is higher than scintigraphy. In breast carcinoma cases, bone, pleura, peritonum and liver metastasis are seen commonly and these localizations must be evaluated carefully with breast MRI. MIP and diffusion weighted images provide diagnostic contributions.

Keywords: Breast carcinoma, bone metastasis, diffusion weighted imaging, magnetic resonance imaging, multiplanary maximum intensity projection (MIP)