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Page 1: 34 Dr Ahmed Esawy imaging oral board of breast imaging part II (magnetic resonance mammography ,breast implants)
Page 2: 34 Dr Ahmed Esawy imaging oral board of breast imaging part II (magnetic resonance mammography ,breast implants)
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The Art of Radiology

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Duct ectasia

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Fat containing lesionslymph nodes – 2nd look US

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Fat containing lesionsLipomas

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Fat containing lesionsHamartomas

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Intraductal papilloma

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Intraductal papillomacentral

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Central intraductal papillomaUS technique

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Ductography, filling defect

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Intraductal papillomacentral

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Complex cysts

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Papillary lesionsperipheral

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Papillary lesionsperipheral

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Papillary lesions

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Sebaceous cysts, Montgomery gland cysts, Epidermal inclusion cysts

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Sebaceous cyst, Epidermal inclusion cyst

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?

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Mondor’s disease: acute superficial thrombosis of

the breast veins.

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Hemangioma

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Neurofibroma

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Suggested approachbreast nodules

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Suggested approachbreast cysts

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Malignant Breast Lesions

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Ca are found at periphery of parenchyma

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Malignant lesions: A.Ducts1) DCIS:Poorly differentiated

Comedo Ca

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Malignant lesions: A.Ducts1) DCIS:Poorly differentiated Comedo Ca

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Malignant lesions: A.Ducts1) DCIS:Poorly differentiated Comedo Ca

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Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous

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Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous

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Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous

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Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous

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Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous

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Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous

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Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous

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Malignant lesions: A.Ducts2) Invasive Duct Ca “NOS”=Scirrhous

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Malignant lesions: A.Ducts3) Colloid or Mucinous Carcinoma

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Malignant lesions: A.Ducts4) Medullary Ca

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Malignant lesions: A.Ducts4) Medullary Ca

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Malignant lesions: A.Ducts5) Inflammatory Ca

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Malignant lesions: B.Stromal Phylloide’s tumour

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Malignant lesions: B.Stromal Phylloide’s tumour

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Malignant lesions: B.Stromal Phylloide’s tumour

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Malignant lesions: C.Metastases

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Malignant lesions: C.Metastases

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Malignant lesions: C.Metastases

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Malignant lesions: C.Metastases

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Malignant lesions :

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Differential Diagnosis :

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56-year-old woman presented for a screening mammogram. She had a history of prior breast implants that were removed several years ago.

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Differential Diagnosis

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MRI BREASTMRM

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MRI BIRADS Lexicon

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Technique: MRI Sequences

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Technique: MRI Sequences

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Technique: MRI Sequences

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Technique: MRI Sequences

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MRI: Why Fat Suppression?

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Technique: MRI Sequences

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Assessment

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Dynamic Enhancement Patterns

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Benign Enhancement Pattern

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Malignant-like Enhancement

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MR Diffusion

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MR Diffusion

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Normal MRS of the Breast

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Normal MRS of the Breast

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Normal MRS of the Breast

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Normal MRS of the Breast

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Normal MRS of the Breast

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How to analyse a spectrum

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How to analyse a spectrum

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1H MRS Study of Breast Cancer

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1H MRS Study of Breast Cancer

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1H MRS Study of Breast Cancer

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1H MRS Study of Breast Cancer

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1H MRS Study of Breast Cancer

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1H MRS Study of Brain Cancer

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Response to chemotherapy

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Response to chemotherapy

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Axilla

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MRS MR DWI

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MRS breast Benefit

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Conclusion: MRS Limitations

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MR DUCTOGRAPHY

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MR guided Stereotactic Biopsy

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MR guided Biopsy

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Radiofrequency

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Case A : Lexicon

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Follow up chemotherapy

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Case A

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Case A

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Pre operative:

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Post Operative& Radiated

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Case B

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Pre operative evaluation

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Case C

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Pre operative

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Pre operative

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Follow up chemotherapy

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CASE D 32 yo with bx proven FA with new palpable lesion

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CASE D 32 yo with bx proven FA

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CASE 41 yo with palp nodule RUIQ

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CASE 41 yo with palp nodule RUIQ

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CASE 41 yo with palp nodule RUIQ

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CASE 41 yo with palp nodule RUIQ

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CAS E 41 yo with palp nodule RUIQ

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CASE H 55 year old - known carcinoma extent of disease

evaluation

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Known left breast carcinoma - scan ordered to evaluate extent of disease

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Pseudo-enhancement due to a subtraction artefact

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Pseudo-enhancement due to a subtraction artefact

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Pseudo-enhancement due to a subtraction artefact

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Invasive breast cancer with morphological findings better seen

on native images

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Rim of enhancement around a fat necrosis

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Non-mass-like enhancement

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Hypersignal on a T2 weighted sequence in invasive ductal carcinoma .

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Missed enhancement

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Misinterpreted enhancement

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BILATERAL BREAST CANCER

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BILATERAL BREAST CANCER

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MULTICENTRIC TUMOUR

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MULTICENTRIC TUMOUR

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MRI: Limitations

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Fibroadenomas: focal mass with round or oval shape and smooth margins, homogenous

internal architecture

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cysts

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cysts

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Imaging abdomen trauma introduction part 1 Dr Ahmed Esawy

Full story pulomnary embolism imaging Dr Ahmed Esawy

9 Dr Ahmed Esawy imaging oral board of skull imaging part I

3 Dr Ahmed Esawy imaging oral board of CNS part III imaging

11 Dr Ahmed Esawy imaging oral board of spine imaging part I

24 Dr Ahmed Esawy imaging oral board of chest imaging part II

Imaging vastitis differentitis funiculitis seminal vesiculitis Dr Ahmed Esawy

19 Dr Ahmed Esawy imaging oral board of neck masses imaging

Dr ahmed esawy imaging of adeniod enlargment

23 Dr Ahmed Esawy imaging oral board of chest imaging (Pulmonary nodules) part I

Imaging abdomen trauma pancreatic trauma part 4 Dr Ahmed Esawy

56-Dr Ahmed Esawy imaging oral board MSK imaging part III

45 Dr Ahmed Esawy imaging oral board of bowel imaging part III(colon )

5 Dr ahmed Esawy imaging oral board of CNS part v imaging

Imaging abdomen trauma liver part 2 Dr Ahmed Esawy

1 Dr Ahmed esawy imaging oral board of CNS part 1 imaging

Imaging abdomen trauma diaphragmatic trauma part 7 Dr Ahmed Esawy

33-Dr Ahmed Esawy imaging oral board of breast imaging part I (mammography )

4 Dr Ahmed esawy imaging oral board of CNS BRAIN part iv imaging

Imaging prostatitis ,urethritis Dr Ahmed Esawy

Imaging abdomen trauma renal part 5 Dr Ahmed Esawy

thyriod gland imaging part 5 (molecular imaging nuclear imaging spect) Dr Ahmed Esawy

Full story fatty liver imaging Dr Ahmed Esawy

6 Dr Ahmed Esawy imaging oral board of CNS part vi imaging

32 Dr Ahmed Esawy imaging oral board of cardio-thoracic imaging (rubens)

21-Dr Ahmed Esawy imaging oral board of cardaic coronary imaging

Full story brain herniation imaging Dr Ahmed Esawy

22 Dr Ahmed Esawy imaging oral board of cardaic CT MRI imaging

35-Dr Ahmed Esawy imaging oral board of breast imaging part III calcification ,magnetic resonance ductography

18 Dr Ahmed Esawy imaging oral board of larynx imaging

13 Dr Ahmed Esawy imaging oral board of spine imaging part III

62-Dr Ahmed Esawy imaging oral board knee imaging part III

36-Dr Ahmed Esawy imaging oral board of biliary gall bladder imaging

42-Dr Ahmed Esawy imaging oral board of splenic peritoneum imaging

15-Dr Ahmed Esawy imaging oral board of sinus ,ear,fascial nerve ,mastiod imaging