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Magnetic resonance imaging findings associated with recurrence in idiopathic granulomatous mastitis

Published:February 03, 2022DOI:https://doi.org/10.1016/j.clinimag.2022.01.010

      Highlights

      • Recurrence in IGM is the most important parameter that limits the quality of life and affects the response to treatment.
      • High background enhancement on magnetic resonance imaging is a risk factor for recurrence.
      • Low ADC value on magnetic resonance imaging is a risk factor for recurrence.
      • The results of our study may be beneficial in treatment planning and follow-up.

      Abstract

      Purpose

      To evaluate magnetic resonance imaging (MRI) findings related to recurrence of idiopathic granulomatous mastitis (IGM).

      Methods

      Demographic data [age, number of births, duration of lactation period, body mass index (BMI) and presence of recurrence] of 71 patients who were diagnosed with IGM were analyzed retrospectively. Characteristics of IGM (maximum width, location, involvement of the retroareolar region, deep tissue, skin), fibroglandular density (FGD), background parenchymal enhancement (BPE), distribution and pattern of contrast enhancement, presence of prepectoral edema, abscesses, fistulae, axillary lymphadenopathies on MRI and apparent diffusion coefficient (ADC) values from the pathological area were recorded.

      Results

      The recurrence rate in patients was 59% (42/71). We found a statistically significant relationship between recurrence and BPE (p = 0.028) and mean ADC (p = 0.035) values (for the cut-off of 1.00 × 10−3 mm2/s; sensitivity = 61.9%, specificity = 69%, AUC = 0.648). However, patients' age (p = 0.346), lactation period (p = 0.470), number of births (p = 0.774), BMI (p = 0.630) maximum width of the area of enhancement (p = 0.112), involvement of the retroareolar region (p = 0.290), deep tissue (p = 0.285), skin (p = 0.230), distribution (p = 0.857) and enhancement pattern (p = 0.157), presence of prepectoral edema (p = 0.094), abscesses (p = 0.441), fistulae (p = 0.809), lymphadenopathies (p = 0.571), and FGT (p = 0.098) were not significantly associated with recurrence.

      Conclusion

      Our results revealed that recurrent IGM patients showed high BPE and lower mean ADC values. We think that high BPE and low mean ADC (<1.00 × 10−3 mm2/s) on MRI at the diagnosis stage may be a sign of possible future recurrence, and it will be beneficial to follow the patients more closely and arrange the treatment algorithms accordingly.

      Keywords

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