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Management of MRI-Detected Benign Internal Mammary Lymph Nodes

Introduction  In this retrospective study, we aimed to evaluate benign internal mammary lymph nodes (IMLNs) in terms of frequency, number, size, long axis/short axis (L/S) ratio, intercostal location, presence of fatty hilum, and stability using breast magnetic resonance imaging (MRI) and discuss th...

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Autores principales: Gunes, Gozde, Crivellaro, Priscila, Muradali, Derek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical and Scientific Publishers Pvt. Ltd. 2022
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9340169/
https://www.ncbi.nlm.nih.gov/pubmed/35924122
http://dx.doi.org/10.1055/s-0042-1750180
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author Gunes, Gozde
Crivellaro, Priscila
Muradali, Derek
author_facet Gunes, Gozde
Crivellaro, Priscila
Muradali, Derek
author_sort Gunes, Gozde
collection PubMed
description Introduction  In this retrospective study, we aimed to evaluate benign internal mammary lymph nodes (IMLNs) in terms of frequency, number, size, long axis/short axis (L/S) ratio, intercostal location, presence of fatty hilum, and stability using breast magnetic resonance imaging (MRI) and discuss the findings by reviewing existing literature. Methods  This single-center study consisted of 130 women between the ages of 24 and 76 years, who had at least two breast MRI examinations in our institution, with the latest exam performed between January 1, 2019 and November 1, 2019, were eligible for the study. MRIs of the study group were independently reviewed by two radiologists. Results  IMLN was detected in 31.1% of the 427 MRIs, with a total number of 256 nodes. The most common indication for breast MRI was high-risk screening (66.2%). The median number of nodes per patient was 1 (range: 1–6). The median follow-up time was 19.5 months (range: 6–141 months). None of these benign nodes showed significant interval growth. Mean L/R ratio of the nodes was 1.9. One hundred and four nodes ( n  = 104, 40.6%) had a L/S ratio less than 2 and 43.2% ( n  = 45) of the nodes with a L/S ratio less than 2, had a long axis measuring less than or equal to 3mm. IMLN of patients with breast implants had the largest mean long axis. The fatty hilum was identified in 34.3% ( n  = 68) of the 256 nodes. The size of the lymph nodes where fatty hilum was visualized was significantly larger than the ones where fatty hilum was not visualized ( p  < 0.001). Fatty hilum could be visualized in only 2.7% of the nodes with a long axis smaller than 3 mm. Conclusion  IMLN is a frequent finding on breast MRI. We have shown that benign IMLNs might be large sized in specific cases like patients with breast implants. When small sized (≤3mm), they are more likely to be rounded (L/S ratio <2). The fatty hilum that is a feature of benignity might not be visualized in nodes less than or equal to3mm.
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spelling pubmed-93401692022-08-02 Management of MRI-Detected Benign Internal Mammary Lymph Nodes Gunes, Gozde Crivellaro, Priscila Muradali, Derek Indian J Radiol Imaging Introduction  In this retrospective study, we aimed to evaluate benign internal mammary lymph nodes (IMLNs) in terms of frequency, number, size, long axis/short axis (L/S) ratio, intercostal location, presence of fatty hilum, and stability using breast magnetic resonance imaging (MRI) and discuss the findings by reviewing existing literature. Methods  This single-center study consisted of 130 women between the ages of 24 and 76 years, who had at least two breast MRI examinations in our institution, with the latest exam performed between January 1, 2019 and November 1, 2019, were eligible for the study. MRIs of the study group were independently reviewed by two radiologists. Results  IMLN was detected in 31.1% of the 427 MRIs, with a total number of 256 nodes. The most common indication for breast MRI was high-risk screening (66.2%). The median number of nodes per patient was 1 (range: 1–6). The median follow-up time was 19.5 months (range: 6–141 months). None of these benign nodes showed significant interval growth. Mean L/R ratio of the nodes was 1.9. One hundred and four nodes ( n  = 104, 40.6%) had a L/S ratio less than 2 and 43.2% ( n  = 45) of the nodes with a L/S ratio less than 2, had a long axis measuring less than or equal to 3mm. IMLN of patients with breast implants had the largest mean long axis. The fatty hilum was identified in 34.3% ( n  = 68) of the 256 nodes. The size of the lymph nodes where fatty hilum was visualized was significantly larger than the ones where fatty hilum was not visualized ( p  < 0.001). Fatty hilum could be visualized in only 2.7% of the nodes with a long axis smaller than 3 mm. Conclusion  IMLN is a frequent finding on breast MRI. We have shown that benign IMLNs might be large sized in specific cases like patients with breast implants. When small sized (≤3mm), they are more likely to be rounded (L/S ratio <2). The fatty hilum that is a feature of benignity might not be visualized in nodes less than or equal to3mm. Thieme Medical and Scientific Publishers Pvt. Ltd. 2022-07-13 /pmc/articles/PMC9340169/ /pubmed/35924122 http://dx.doi.org/10.1055/s-0042-1750180 Text en Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Gunes, Gozde
Crivellaro, Priscila
Muradali, Derek
Management of MRI-Detected Benign Internal Mammary Lymph Nodes
title Management of MRI-Detected Benign Internal Mammary Lymph Nodes
title_full Management of MRI-Detected Benign Internal Mammary Lymph Nodes
title_fullStr Management of MRI-Detected Benign Internal Mammary Lymph Nodes
title_full_unstemmed Management of MRI-Detected Benign Internal Mammary Lymph Nodes
title_short Management of MRI-Detected Benign Internal Mammary Lymph Nodes
title_sort management of mri-detected benign internal mammary lymph nodes
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9340169/
https://www.ncbi.nlm.nih.gov/pubmed/35924122
http://dx.doi.org/10.1055/s-0042-1750180
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