Breast MRI enhancement curves

Last revised by Andrew Murphy on 27 Sep 2021

Following administration of gadolinium, there can be three possible enhancement (time intensity) kinetic curves for a lesion on breast MRI (these are also applied in other organs such as prostate MRI). These are sometimes termed the Kuhl enhancement curves.

  • type I curve: progressive or persistent enhancement pattern
    • typically shows a continuous increase in signal intensity throughout time 
    • usually considered benign with only a small proportion of (~9%) of malignant lesions having this pattern
  • type II curve: plateau pattern
    • initial uptake followed by the plateau phase towards the latter part of the study
    • considered concerning for malignancy
  • type III curve: washout pattern
    • has a relatively rapid uptake shows reduction in enhancement towards the latter part of the study
    • considered strongly suggestive of malignancy

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Cases and figures

  • Case 1: type I enhancement curve - fibroadenoma
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  • Case 2: type I curve
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  • Case 3: type II curve
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  • Case 4: type III curve
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  • Case 5: type I curve
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  • Case 6: low grade phyllodes tumor
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