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Abstract Cancer breast is the most common cancer throughout women. Every year, about 1,500000 women are affected by breast cancer world-wide. WHO declared that the mortality rate from breast cancer among the women in 2015 was about 570,000, and that represents about 50% of the women who died from cancer. So, early detection and differentiation of breast lesions are very useful regarding the plan of treatment and prognosis. (EbrahimY. et al,2018). Breast MRI is an important modality as mammography and US. Its main indications are staging of cancer breast, screening for breast cancer in women with high risk (These include patients with genetic predispositions such as BRCA1 or BRCA2 gene mutation, or a first-degree relative with one of these mutations), and evaluation of response to neoadjuvant chemotherapy. As opposed to mammography and US, MRI is a functional technique. Heywang, Kaiser and Zeitler independently introduced this technique in the 1980s. (Hu, Q.et al,2020). Contrast material–enhanced MRI evaluates the permeability of blood vessels by using an intravenous contrast agent (gadolinium chelate) that shortens the local T1 time, leading to a higher signal on T1-weighted images. The underlying principle is that neoangiogenesis leads to formation of leaky vessels that allow for faster extravasation of contrast agents. So, Most MRI protocols nowadays are multiparametric (Mann RM.et al, 2019). Multi-Parametric MRI (MP -MRI) is a noninvasive methods of tissue characterization, that has attracted a growing clinical interest during the early course of diagnosis. It depends upon the different patterns of breast lesions enhancement and the morphology of breast lesions, which results in the high sensitivity of the MRI up to 100%, but lacks specificity for characterizing the lesions (EbrahimY. et al, 2018). Recently, there is increased using multi-parametric MRI for assessment of different breast lesions. So, the combination of both conventional dynamic contrast enhanced MRI as well as the different functional MRI techniques including MR perfusion (dynamic curve), diffusion-weighted MRI (DW-MRI) as well as proton MR spectroscopy ( 1 H-MRS) result in increasing the performance of MRI in diagnosis of Introduction 14 different breast diseases . One of the non-contrast sequences is the DWI (diffusion- weighted images) that can be used as a complementary tool to DCE-MRI. Proton MR Spectroscopy describes the tumor biochemistry and levels of different metabolites. It can be added to the standard MRI protocols to characterize benign from malignant(Mann RM et al,2019). |