Retrospective Study on the Place of 1.5 Tesla MRI in the Management of Breast Pathology in Douala

Abstract

Aim: Magnetic resonance imaging is the most sensitive imaging technique for the detection of breast cancer, although it is rarely requested as a first-line procedure. The aim of our study was to determine the indications and results of breast examinations using 1.5 Tesla MRI in a referral imaging centre in Douala. Methodology: We conducted a retrospective descriptive cross-sectional study between 01 March 2021 and 31 December 2022. The examinations were performed with a dedicated breast scanner, using axial and sagittal T1 SE and T2 FSE sequences, as well as dynamic T1 sequences with gadolinium injection, and interpreted by two experienced radiologists. According to the BIRADS classification of the American College of Radiology (ACR), examinations graded 4 to 5 were considered positive. Results: Thirty-five patients underwent breast MRI, with a median age of 47, ranging from 29 to 65 years. The vast majority of prescribers were gynaecologists (88.6%). The most common indication for MRI was for additional assessment of a lesion (34.2%), followed by assessment of locoregional extension (17.1%), particularly for multiple extensions. All investigations requested solely for mastodynia (14.3%) were unremarkable. The two cases of investigation of breast discharge were mainly associated with enhancement without mass (5.7%). At the end of the study, 28.5% of MRI scans were pathological according to BIRADS. Conclusion: The gradual introduction of 1.5 T MRI scanners in our environment means that we can now carry out breast MRI scans that are much more sensitive than ultrasound mammography. However, prescriptions are still highly specialised, and indications need to be verified, given their relative specificity and the socio-economic context in which our countries are evolving.