Dynamic contrast-enhanced MRI (DCE-MRI) features of diabetic mastopathy in T1DM and T2DM: Case report and a review of the literature

Background: The aim of this study was to investigate the imaging features of diabetic mastopathy (DMP) in patients with type 1 and 2 diabetes mellitus (DM) to improve the diagnostic process. In addition, we report two cases from the study hospital and provide a review of the relevant literature. Methods: Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and pathological findings of patients with diabetic mastopathy (DMP) were reviewed. We searched for DMP studies that included DCE-MRI information between 1980 and 2021 using the MEDLINE database. Cases were dichotomized into two groups: type 1 DM with DMP (T1DMP) and type 2 DM with DMP (T2DMP). DCE-MRI features were compared between the two groups. Statistical analyses were performed using two-sample t-tests and Fisher's exact chi-square tests. Results: We retrieved 21 cases of DMP (2/21 were patients of our hospital): 11 patients with T1DMP and 10 with T2DMP. Patients had a 10-to 42-year history of DM. The average onset of age in the T1DMP and T2DMP groups was 41.90 +/- 12.261 and 65.00 +/- 8.233 years, respectively. Twelve benign lesions presented with no enhancement or mild gradual enhancement (10 cases, T1DMP; 2 cases, T2DMP), and 9 cases showed malignant or suspicious lesions with mass or non-mass early intense enhancement on DCE-MRI (1 case, T1DMP; 8 cases, T2DMP). A comparison of DCE-MRI features between the two DMP groups showed a statistically sig-nificant difference (p < 0.001). Conclusion: DMP is more likely to occur in patients with long-term poorly controlled DM. MRI findings may support a diagnosis of DMP. Two DCE-MRI types were observed in patients with DMP. Mild gradual enhancement dominated in masses of patients with T1DMP, while intense early enhancement dominated in those with T2DMP, which suggested suspicious or malignant MRI characteristics.