Books of abstracts, XIV Balkan Congressof Radiology 2016, Thessaloniki, Greece
Magnetic resonance imaging (MRI) is the most useful imaging modality for the characterisation of breast implants, because of its high spatial resolution and contrast between implants and soft tissues and absence of ionising radiation. An intracapsular rupture(85%) occurs when the shell of the implant ruptures but the fibrous capsule formed by the breast remains intact. A gross extra-capsular rupture(15%) is evident as free silicone, separate from the implant,which has extended beyond the implant capsule into the breast or axilla. Free silicone has an increased signal in STIR sequence without any enhancement in T1 weighted fat-suppressed sequence.
Asymptomatic 20-year-old lady with previous implants due to subcutaneous mastectomy, and with chronic extracapsular implant rupture of the left breast. The rupture was seen on MRI. She underwent punction and aspiration several times, but at the end,the implant was surgically removed.
Materials and Methods:
Axial T2W tomograms and dynamic T1W studies of both breasts were performed.
The left implant had small volume but held in the integrity of the capsule. The implant was surrounded by a large amount of clear liquid content. Left breast was significantly larger in volume,comparing to the right breast. After administration of the contrast,there was no significant gain in signal intensity in the remaining breast tissue. No MR elements of disease relapse were found; nor pericapsular/capsular signal intensity gain was seen, which would indicate inflammation. In the left axilla no significant lymph nodes enlargement was seen.
Radiologists need to be able to recognise the normal appearance of commonly used implants on various imaging techniques. The role of MRI in the evaluation of breast implants resides in implant integrity evaluation and breast cancer detection (especially in women with oncoplastic reconstructive surgery).
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