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T2 Hyperintensity (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

            • Definitions

              • ↑ signal compared to adjacent breast parenchyma on T2 MR (long TR, long TE) sequences
                • Includes inversion recovery (STIR) and fat-suppressed T2 sequences
                • ↓ signal when water suppression applied
              • Myxoid = mucoid

            IMAGING

            • General Features

              • Mammographic Findings

                • Ultrasonographic Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          DIAGNOSTIC CHECKLIST

                          • Consider

                            • Image Interpretation Pearls

                              Selected References

                              1. Grimm et al: Solitary, Well-Circumscribed, T2 Hyperintense Masses on MRI Have Very Low Malignancy Rates. Journal of Breast Imaging, 2019, 1–6 doi:10.1093/jbi/wby014
                              2. Cheon H et al: Invasive breast cancer: Prognostic value of peritumoral edema identified at preoperative MR imaging. Radiology. 171157, 2018
                              3. Bae MS et al: Pretreatment MR imaging features of triple-negative breast cancer: Association with response to neoadjuvant chemotherapy and recurrence-free survival. Radiology. 281(2):392-400, 2016
                              4. Uematsu T: MRI findings of inflammatory breast cancer, locally advanced breast cancer, and acute mastitis: T2-weighted images can increase the specificity of inflammatory breast cancer. Breast Cancer. 19(4):289-94, 2012
                              5. Baltzer PA et al: Nonmass lesions in magnetic resonance imaging of the breast: additional T2-weighted images improve diagnostic accuracy. J Comput Assist Tomogr. 35(3):361-6, 2011
                              6. Kawashima H et al: Triple-negative breast cancer: are the imaging findings different between responders and nonresponders to neoadjuvant chemotherapy? Acad Radiol. 18(8):963-9, 2011
                              7. 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
                              8. Baltzer PA et al: Sensitivity and specificity of unilateral edema on T2w-TSE sequences in MR-Mammography considering 974 histologically verified lesions. Breast J. 16(3):233-9, 2010
                              9. Kawashima H et al: Peripheral hyperintense pattern on T2-weighted magnetic resonance imaging (MRI) in breast carcinoma: correlation with early peripheral enhancement on dynamic MRI and histopathologic findings. J Magn Reson Imaging. 32(5):1117-23, 2010
                              10. Linda A et al: Unusual malignant tumors of the breast: MRI features and pathologic correlation. Eur J Radiol. 75(2):178-84, 2010
                              11. Santamaría G et al: Radiologic and pathologic findings in breast tumors with high signal intensity on T2-weighted MR images. Radiographics. 30(2):533-48, 2010
                              12. Uematsu T et al: Neoadjuvant chemotherapy for breast cancer: correlation between the baseline MR imaging findings and responses to therapy. Eur Radiol. 20(10):2315-22, 2010
                              13. Ballesio L et al: Breast MRI: Are T2 IR sequences useful in the evaluation of breast lesions? Eur J Radiol. 71(1):96-101, 2009
                              14. Uematsu T et al: Triple-negative breast cancer: correlation between MR imaging and pathologic findings. Radiology. 250(3):638-47, 2009
                              15. Okafuji T et al: MR imaging features of pure mucinous carcinoma of the breast. Eur J Radiol. 60(3):405-13, 2006
                              16. Yabuuchi H et al: Phyllodes tumor of the breast: correlation between MR findings and histologic grade. Radiology. 241(3):702-9, 2006
                              17. Malich A et al: Potential MRI interpretation model: differentiation of benign from malignant breast masses. AJR Am J Roentgenol. 185(4):964-70, 2005
                              18. Wurdinger S et al: Differentiation of phyllodes breast tumors from fibroadenomas on MRI. AJR Am J Roentgenol. 185(5):1317-21, 2005
                              19. Kinoshita T et al: Magnetic resonance imaging of benign phyllodes tumors of the breast. Breast J. 10(3):232-6, 2004
                              20. Liberman L et al: Breast lesions detected on MR imaging: features and positive predictive value. AJR Am J Roentgenol. 179(1):171-8, 2002
                              21. Kuhl CK et al: Do T2-weighted pulse sequences help with the differential diagnosis of enhancing lesions in dynamic breast MRI? J Magn Reson Imaging. 9(2):187-96, 1999
                              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

                                        • Definitions

                                          • ↑ signal compared to adjacent breast parenchyma on T2 MR (long TR, long TE) sequences
                                            • Includes inversion recovery (STIR) and fat-suppressed T2 sequences
                                            • ↓ signal when water suppression applied
                                          • Myxoid = mucoid

                                        IMAGING

                                        • General Features

                                          • Mammographic Findings

                                            • Ultrasonographic Findings

                                              • MR Findings

                                                • Imaging Recommendations

                                                  DIFFERENTIAL DIAGNOSIS

                                                    PATHOLOGY

                                                    • General Features

                                                      DIAGNOSTIC CHECKLIST

                                                      • Consider

                                                        • Image Interpretation Pearls

                                                          Selected References

                                                          1. Grimm et al: Solitary, Well-Circumscribed, T2 Hyperintense Masses on MRI Have Very Low Malignancy Rates. Journal of Breast Imaging, 2019, 1–6 doi:10.1093/jbi/wby014
                                                          2. Cheon H et al: Invasive breast cancer: Prognostic value of peritumoral edema identified at preoperative MR imaging. Radiology. 171157, 2018
                                                          3. Bae MS et al: Pretreatment MR imaging features of triple-negative breast cancer: Association with response to neoadjuvant chemotherapy and recurrence-free survival. Radiology. 281(2):392-400, 2016
                                                          4. Uematsu T: MRI findings of inflammatory breast cancer, locally advanced breast cancer, and acute mastitis: T2-weighted images can increase the specificity of inflammatory breast cancer. Breast Cancer. 19(4):289-94, 2012
                                                          5. Baltzer PA et al: Nonmass lesions in magnetic resonance imaging of the breast: additional T2-weighted images improve diagnostic accuracy. J Comput Assist Tomogr. 35(3):361-6, 2011
                                                          6. Kawashima H et al: Triple-negative breast cancer: are the imaging findings different between responders and nonresponders to neoadjuvant chemotherapy? Acad Radiol. 18(8):963-9, 2011
                                                          7. 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
                                                          8. Baltzer PA et al: Sensitivity and specificity of unilateral edema on T2w-TSE sequences in MR-Mammography considering 974 histologically verified lesions. Breast J. 16(3):233-9, 2010
                                                          9. Kawashima H et al: Peripheral hyperintense pattern on T2-weighted magnetic resonance imaging (MRI) in breast carcinoma: correlation with early peripheral enhancement on dynamic MRI and histopathologic findings. J Magn Reson Imaging. 32(5):1117-23, 2010
                                                          10. Linda A et al: Unusual malignant tumors of the breast: MRI features and pathologic correlation. Eur J Radiol. 75(2):178-84, 2010
                                                          11. Santamaría G et al: Radiologic and pathologic findings in breast tumors with high signal intensity on T2-weighted MR images. Radiographics. 30(2):533-48, 2010
                                                          12. Uematsu T et al: Neoadjuvant chemotherapy for breast cancer: correlation between the baseline MR imaging findings and responses to therapy. Eur Radiol. 20(10):2315-22, 2010
                                                          13. Ballesio L et al: Breast MRI: Are T2 IR sequences useful in the evaluation of breast lesions? Eur J Radiol. 71(1):96-101, 2009
                                                          14. Uematsu T et al: Triple-negative breast cancer: correlation between MR imaging and pathologic findings. Radiology. 250(3):638-47, 2009
                                                          15. Okafuji T et al: MR imaging features of pure mucinous carcinoma of the breast. Eur J Radiol. 60(3):405-13, 2006
                                                          16. Yabuuchi H et al: Phyllodes tumor of the breast: correlation between MR findings and histologic grade. Radiology. 241(3):702-9, 2006
                                                          17. Malich A et al: Potential MRI interpretation model: differentiation of benign from malignant breast masses. AJR Am J Roentgenol. 185(4):964-70, 2005
                                                          18. Wurdinger S et al: Differentiation of phyllodes breast tumors from fibroadenomas on MRI. AJR Am J Roentgenol. 185(5):1317-21, 2005
                                                          19. Kinoshita T et al: Magnetic resonance imaging of benign phyllodes tumors of the breast. Breast J. 10(3):232-6, 2004
                                                          20. Liberman L et al: Breast lesions detected on MR imaging: features and positive predictive value. AJR Am J Roentgenol. 179(1):171-8, 2002
                                                          21. Kuhl CK et al: Do T2-weighted pulse sequences help with the differential diagnosis of enhancing lesions in dynamic breast MRI? J Magn Reson Imaging. 9(2):187-96, 1999