Abstract:

Background and purpose: Histological grade of DCIS is an important factor in the prognosis,high nuclear grade have higher infiltration trend and recurrence rate. This study aimed to evaluate the dynamic and morphological MRI charactristics of ductal carcinoma in situ (DCIS) of the breast, then analyze its relations with nuclear grade. Methods: Of the 94 patients, 97 lesions were proved DCIS by pathology. The morphology, maximum size, time- intensity curve of lesion were recorded or measured. Statistic was performed to identify MR imaging features that optimally discriminated HNG from non-HNG DCIS. Results: There were 49 non mass-like enhancement lesions, and 48 masses enhancement lesions. Among 49 non mass-like lesions, 29 were segmental enhancement (59.18%). Dynamic enhanced performance: 50 exhibited plateau curves and 27 were washout curves. BI-RADS categories: 22 BI-RADS 4A, 19 BI-RADS 4B, 29 BI-RADS 4C, and 27 BI-RADS 5. HNG lesions exhibited larger mean maximum lesion size (non-mass-like enhancement: P=0.01; mass: P=0.03), time- intensity curve was variable to approach significance (P=0.01), and BI-RADS can help to discriminate the nuclear grade (P=0.02). There were no differences in lesion morphology (P>0.05). Conclusion: The preliminary findings suggest that DCE MR imaging features may aid in identifying patients with high risk DCIS.

Key words: Ductal carcinoma in situ, MRI, BI-RADS, Nuclear grade