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Linear Enhancement (MR)
Katie M. Davis, DO; Wendie A. Berg, MD, PhD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Ductal enhancement
            • Definitions

              • Nonmass enhancement (NME): Enhancement discrete from background that is neither focus nor mass
              • Linear: Describes distribution of NME
                • Arrayed in line (linear) or line that branches (linear branching)
              • Distinguish from segmental distribution: Triangle or cone of enhancement with apex pointing to nipple, involving lobe/segment of breast
              • Characterize internal enhancement pattern of NME
                • Homogeneous: Confluent, uniform
                • Heterogeneous: Nonuniform, random pattern, intervening normal parenchyma or fat
                • Clumped: Cobblestone pattern, various shapes and sizes, occasionally confluent; suspicious for DCIS
                • Clustered ring: Thin rings clustered in periductal stroma; suspicious for DCIS

            IMAGING

            • General Features

              • Mammographic Findings

                • Ultrasonographic Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          DIAGNOSTIC CHECKLIST

                          • Consider

                            Selected References

                            1. Asada T et al: Grading system to categorize breast MRI using BI-RADS 5th edition: a statistical study of non-mass enhancement descriptors in terms of probability of malignancy. Jpn J Radiol. 36(3):200-208, 2018
                            2. Dratwa C et al: Breast MR biopsy: pathological and radiological correlation. Eur Radiol. 26(8):2510-9, 2016
                            3. Machida Y et al: Two distinct types of linear distribution in nonmass enhancement at breast MR imaging: difference in positive predictive value between linear and branching patterns. Radiology. 276(3):686-94, 2015
                            4. Greenwood HI et al: Ductal carcinoma in situ of the breasts: review of MR imaging features. Radiographics. 33(6):1569-88, 2013
                            5. Morris EA, Comstock CE, Lee CH, et al. ACR BI-RADS® Magnetic Resonance Imaging. In: ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System. Reston, VA, American College of Radiology; 2013
                            6. Tozaki M: BI-RADS-MRI terminology and evaluation of intraductal carcinoma and ductal carcinoma in situ. Breast Cancer. 20(1):13-20, 2013
                            7. Lee SJ et al: MRI features of stromal fibrosis of the breast with histopathologic correlation. AJR Am J Roentgenol. 197(3):755-62, 2011
                            8. Sohns C et al: Value of the BI-RADS classification in MR-Mammography for diagnosis of benign and malignant breast tumors. Eur Radiol. 21(12):2475-83, 2011
                            9. Mossa-Basha M et al: Ductal carcinoma in situ of the breast: MR imaging findings with histopathologic correlation. Radiographics. 30(6):1673-87, 2010
                            10. Lee SH et al: Correlation between high resolution dynamic MR features and prognostic factors in breast cancer. Korean J Radiol. 9(1):10-8, 2008
                            11. Sakamoto N et al: Categorization of non-mass-like breast lesions detected by MRI. Breast Cancer. 15(3):241-6, 2008
                            12. Jansen SA et al: Pure ductal carcinoma in situ: kinetic and morphologic MR characteristics compared with mammographic appearance and nuclear grade. Radiology. 245(3):684-91, 2007
                            13. Kuhl CK et al: MRI for diagnosis of pure ductal carcinoma in situ: a prospective observational study. Lancet. 370(9586):485-92, 2007
                            14. Van Goethem M et al: MR mammography is useful in the preoperative locoregional staging of breast carcinomas with extensive intraductal component. Eur J Radiol. 62(2):273-82, 2007
                            15. Schnall MD et al: Diagnostic architectural and dynamic features at breast MR imaging: multicenter study. Radiology. 238(1):42-53, 2006
                            16. Morakkabati-Spitz N et al: Diagnostic usefulness of segmental and linear enhancement in dynamic breast MRI. Eur Radiol. 15(9):2010-7, 2005
                            17. Liberman L et al: Ductal enhancement on MR imaging of the breast. AJR Am J Roentgenol. 181(2):519-25, 2003
                            18. Liberman L et al: Breast lesions detected on MR imaging: features and positive predictive value. AJR Am J Roentgenol. 179(1):171-8, 2002
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Terminology

                              • Imaging

                                • Top Differential Diagnoses

                                  • Pathology

                                    • Diagnostic Checklist

                                      TERMINOLOGY

                                      • Synonyms

                                        • Ductal enhancement
                                      • Definitions

                                        • Nonmass enhancement (NME): Enhancement discrete from background that is neither focus nor mass
                                        • Linear: Describes distribution of NME
                                          • Arrayed in line (linear) or line that branches (linear branching)
                                        • Distinguish from segmental distribution: Triangle or cone of enhancement with apex pointing to nipple, involving lobe/segment of breast
                                        • Characterize internal enhancement pattern of NME
                                          • Homogeneous: Confluent, uniform
                                          • Heterogeneous: Nonuniform, random pattern, intervening normal parenchyma or fat
                                          • Clumped: Cobblestone pattern, various shapes and sizes, occasionally confluent; suspicious for DCIS
                                          • Clustered ring: Thin rings clustered in periductal stroma; suspicious for DCIS

                                      IMAGING

                                      • General Features

                                        • Mammographic Findings

                                          • Ultrasonographic Findings

                                            • MR Findings

                                              • Imaging Recommendations

                                                DIFFERENTIAL DIAGNOSIS

                                                  PATHOLOGY

                                                  • General Features

                                                    DIAGNOSTIC CHECKLIST

                                                    • Consider

                                                      Selected References

                                                      1. Asada T et al: Grading system to categorize breast MRI using BI-RADS 5th edition: a statistical study of non-mass enhancement descriptors in terms of probability of malignancy. Jpn J Radiol. 36(3):200-208, 2018
                                                      2. Dratwa C et al: Breast MR biopsy: pathological and radiological correlation. Eur Radiol. 26(8):2510-9, 2016
                                                      3. Machida Y et al: Two distinct types of linear distribution in nonmass enhancement at breast MR imaging: difference in positive predictive value between linear and branching patterns. Radiology. 276(3):686-94, 2015
                                                      4. Greenwood HI et al: Ductal carcinoma in situ of the breasts: review of MR imaging features. Radiographics. 33(6):1569-88, 2013
                                                      5. Morris EA, Comstock CE, Lee CH, et al. ACR BI-RADS® Magnetic Resonance Imaging. In: ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System. Reston, VA, American College of Radiology; 2013
                                                      6. Tozaki M: BI-RADS-MRI terminology and evaluation of intraductal carcinoma and ductal carcinoma in situ. Breast Cancer. 20(1):13-20, 2013
                                                      7. Lee SJ et al: MRI features of stromal fibrosis of the breast with histopathologic correlation. AJR Am J Roentgenol. 197(3):755-62, 2011
                                                      8. Sohns C et al: Value of the BI-RADS classification in MR-Mammography for diagnosis of benign and malignant breast tumors. Eur Radiol. 21(12):2475-83, 2011
                                                      9. Mossa-Basha M et al: Ductal carcinoma in situ of the breast: MR imaging findings with histopathologic correlation. Radiographics. 30(6):1673-87, 2010
                                                      10. Lee SH et al: Correlation between high resolution dynamic MR features and prognostic factors in breast cancer. Korean J Radiol. 9(1):10-8, 2008
                                                      11. Sakamoto N et al: Categorization of non-mass-like breast lesions detected by MRI. Breast Cancer. 15(3):241-6, 2008
                                                      12. Jansen SA et al: Pure ductal carcinoma in situ: kinetic and morphologic MR characteristics compared with mammographic appearance and nuclear grade. Radiology. 245(3):684-91, 2007
                                                      13. Kuhl CK et al: MRI for diagnosis of pure ductal carcinoma in situ: a prospective observational study. Lancet. 370(9586):485-92, 2007
                                                      14. Van Goethem M et al: MR mammography is useful in the preoperative locoregional staging of breast carcinomas with extensive intraductal component. Eur J Radiol. 62(2):273-82, 2007
                                                      15. Schnall MD et al: Diagnostic architectural and dynamic features at breast MR imaging: multicenter study. Radiology. 238(1):42-53, 2006
                                                      16. Morakkabati-Spitz N et al: Diagnostic usefulness of segmental and linear enhancement in dynamic breast MRI. Eur Radiol. 15(9):2010-7, 2005
                                                      17. Liberman L et al: Ductal enhancement on MR imaging of the breast. AJR Am J Roentgenol. 181(2):519-25, 2003
                                                      18. Liberman L et al: Breast lesions detected on MR imaging: features and positive predictive value. AJR Am J Roentgenol. 179(1):171-8, 2002