Breast Ultrasound MR Imaging Correlation

Sonographic correlation of breast lesions detected on MR imaging is becoming a popular alternative to MR imaging-guided interventions. Sonographic correlation allows ultrasound-guided biopsy and needle localization as well as sonographic follow-up. Clinical studies have shown that malignant lesions seem to be significantly more likely than benign lesions to have sonographic correlates. Success rates for correlation of sonography and MR imaging are higher in patients undergoing dynamic breast MR imaging for high-risk screening or to search for occult breast carcinoma that has metastasized to the axillary lymph nodes than in other patient groups. Technically, it is important to perform three-plane reformatting to determine lesion characteristics such as size and morphology and to calculate the distance from the nipple and the skin. An appropriate differential diagnosis, based on the MR imaging findings, should be formulated. For lesions that are difficult to correlate, placing a vitamin E capsule or a marker on the skin may help with lesion localization. For lesions with discordant imaging and pathologic findings after targeted sonography and sonography-guided biopsy, placing a clip marker after biopsy and repeating the MR imaging may help to localize the lesion in question.