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BI-RADS Descriptors Tool

Interactive Breast Imaging Lexicon for Mammography, Ultrasound & MRI

1. Imaging Modality

BI-RADS Reference

Mammography Key Points

Suspicious Features:
  • Spiculated margins: Highly suspicious for malignancy
  • Fine pleomorphic calcifications: High concern
  • Fine linear calcifications: Very high suspicion
  • Developing asymmetry: New or increasing
Benign Features:
  • Circumscribed margins: Usually benign
  • Fat-containing: Benign (lipoma, hamartoma)
  • Skin calcifications: Benign
  • Vascular calcifications: Benign

Ultrasound Key Points

Suspicious Features:
  • Not parallel orientation: Taller than wide
  • Spiculated margins: High suspicion
  • Posterior shadowing: May indicate malignancy
  • Marked hypoechogenicity: Concerning feature
Benign Features:
  • Parallel orientation: Wider than tall
  • Circumscribed margins: Usually benign
  • Posterior enhancement: Often benign
  • Simple cyst: Anechoic with enhancement

MRI Key Points

Suspicious Features:
  • Washout kinetics: Highly suspicious
  • Rim enhancement: Concerning pattern
  • Spiculated margins: High suspicion
  • Restricted diffusion: May indicate malignancy
Benign Features:
  • Persistent kinetics: Usually benign
  • T2 bright signal: Often cystic/benign
  • Dark septations: Typical of fibroadenoma
  • Circumscribed margins: Usually benign

Important Notes:

  • This tool is for educational purposes and descriptor reference only
  • Clinical correlation and institutional guidelines should always be considered
  • BI-RADS assessment should include all relevant imaging findings
  • Management recommendations follow ACR BI-RADS guidelines

Based on ACR BI-RADS Atlas 5th Edition

Reference: ACR BI-RADS Resources