0:01

Okay, our next case for protocol and anatomy

0:05

is a 31-year-old woman who is seen for high

0:08

risk screening, and she has a family history of

0:10

breast cancer and four relatives at young ages.

0:14

So, appropriately being seen

0:17

for high-risk screening. Mr.

0:19

We'll go to our case.

0:23

So this is our, our case.

0:25

I won't go through the localizer here, but this

0:28

is the T1-weighted, non-fat saturated series,

0:33

and I just wanted to show you this in a patient

0:35

who has a larger breast size, kind of a larger

0:38

sized patient with fattier breast tissue.

0:43

So just going from the top, you

0:46

can see that the patient has a lot

0:48

of axillary tissue on both sides.

0:52

Pectoralis minor and major muscles are

0:55

well seen and are lower signal intensity.

1:00

There's a lot of fatty tissue here.

1:01

So that's high signal intensity.

1:09

Kind of going through that, but no, so a bigger

1:12

patient, we can still fit the patient in, we

1:15

can still get the nipples pointing downward.

1:20

And of course, you know, by convention,

1:24

we image prone, but we display the

1:29

images as if the patient is.

1:32

Lying on her back, but keep in mind

1:36

that the patient is always prone.

1:40

And going through that STIR sequence,

1:44

this is a sort of a quieter

1:47

breast than the last one we looked at.

1:50

There are some lymph nodes in the

1:52

axilla, and then, you know, not

1:58

too much going on in the breast.

2:01

This is our pre-contrast sequence. Sometimes,

2:05

with very fatty breast tissue, it can

2:08

be hard to do fat saturation, especially

2:11

at the top and bottom of the exam.

2:14

You can see some areas where our fat saturation

2:17

is a little bit inhomogeneous, but in the breast

2:22

itself, we've actually done a pretty good job.

2:25

You can see most of that fat is well

2:28

saturated, even down to the last image.

2:35

And then after contrast, we get some

2:39

enhancement of our blood vessels.

2:41

You can see internal mammary artery

2:42

and vein are enhancing, and liver.

2:48

This patient doesn't have very much

2:51

enhancement in her breast tissue.

2:57

Then there's to show you her

3:03

And you can see lots of blood vessels

3:05

here on the maximum intensity projection

3:07

image, a little bit of tissue enhancement,

3:12

really nothing significant here.