Time Intensity Curve Analysis of Malignant Enhancing Breast Lesions: Atypical Findings More Frequent in Smaller Lesions

Dorothee Barbara Engel¹, Winifred Dunbar², Fred Kelcz²

Dynamic contrast-enhanced (DCE) breast MRI has become the mainstay for assessing breast problems not resolved by mammography and ultrasound. A signal intensity vs. time curve showing rapid gadolinium contrast uptake and delayed washout is typically associated with malignancy, but our study of 81 malignant spanning a wide size range showed that the typical pattern was only in lesions > 1 cm. A delayed persistent pattern may be seen in up to 20% of sub-centimeter lesions. Radiologists should be aware of these exceptions and emphasize morphology over contrast enhancement for small lesions.