Gestion des images additionnelles en IRMÂ : le bilan de second-look

Second-look studies are performed to establish or exclude the presence of a correlative lesion in case of abnormal MR enhancement. Lesion detection at targeted ultrasound is improved by reviewing the MRI exam, by understanding the differences in breast position, and by recognizing the possible differences in presentation of identical lesions at US and MR imaging. It may occasionally be useful, particularly for non-mass-mike enhancements, to perform additional mammographic views (magnified views of the targeted area to reveal microcalcifications). Digital breast tomosynthesis 3D can help to identify subtle architectural distorsion. The general detection rate at second-look studies are very heterogeneous; malignant and mass lesions are more likely to be detected at second-look ultrasound; malignancy cannot be excluded if a lesion is not detected at second-look studies. After a percutaneous biopsy a metallic marker must be placed at the site of the biopsy to ensure correct correlation between imaging modalities.