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MR makes a difference in diagnosis for patients with breast implants

Case Study
Rossi, Santiago, M.D. Centro de Diagnostico Dr. Enrique Rossi • Argentina
Dr. Volpacchio, Mariano, M.D. Centro de Diagnostico Dr. Enrique Rossi • Argentina

Patient history

68-year-old female with history of 15-year-old breast implants presents with a nodule on her upper outer quadrant of the left breast.  

MR Examination

Achieva 3.0T TX with SENSE Breast 7 coil is used.  

Contrast agent used Gadoversetamida 20 ml with 20 ml of saline solution (2 ml per second). Infusion Pump is used.


 Sagittal T2
Sagittal T2
 Silicone only STIR Axial
Silicone only
STIR Axial
 T2W Axial Thrive Axial
T2W Axial
Thrive Axial


Sagittal T2 shows retroglandular breast implants.
Silicone only shows breast implants with hypointense lines, that represent intracapsular rupture.  No extracapsular rupture is seen. No further abnormalities.
On STIR no adenomegalies are seen.
Axial T2 shows a nodule with poorly defined margins of 18.6 mm x 14.4 mm in the left breast prior to i.v. contrast. 
On THRIVE (6 Dynamics with substraction) a nodule is seen on the left breast with heterogeneous enhancement.The results showed a Curve type 3, referring to perfusion of the angiogenesis.


Invasive Ductal Carcinoma is suspected.

Clinical impact of using SENSE Breast 7 TX coil

MR made a difference in the diagnosis because as this patient had implants and she touched a nodule that wasn´t seen on the mammogram; MR helped to visualize the nodule and its limits, it also helped to evaluate the other breast and both implants.  It helped to determine if the nodule was multicentric or localized.
Other modalities used to make diagnosis were Digital Mammogram with eclum technique and Ultrasound.  On the digital mammogram bilateral implants and dense glandular tissue were seen, but no signs of the mass could be appreciated. Ultrasound showed a hypoechoic nodule with imprecise margins, heterogenous and solid in comparison to MRI. 
Breast MRI has become an essential tool to evaluate special situations. With this coil, breast imaging has reached a level of quality in a shorter time helping us to define pathology on our daily case scenarios.

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Feb 21, 2012

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Case Study
Achieva 3.0T
Body, breast, carcinoma, SENSE Breast 7TX coil

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