MRI for Evaluation of Complications of Breast Augmentation

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Breast Sonography: 1.00
Procedures: 1.00
Breast Interventions: 1.00

Mammography: 1.00
Procedures: 1.00
Mammographic Positioning, Special Needs, and Imaging Procedures: 1.00

Magnetic Resonance Imaging: 2.00
Procedures: 2.00
Body: 2.00

Registered Radiologist Assistant: 2.00
Procedures: 2.00
Thoracic Section: 2.00

Sonography: 1.00
Procedures: 1.00
Superficial Structures and Other Sonographic Procedures: 1.00

Outline

1. Introduction
2. Breast Implant Classification
   1. Implant Type
   2. Implant Lumen
   3. Implant Texture
   4. Implant Location
3. MRI Evaluation of the Augmented Breast and Recommended Protocol
4. Normal Findings at MRI of Patients with Breast Implants
   1. Radial Folds
   2. Peri-Implant Fluid
5. Complications of Breast Implants
   1. Peri-Implant Collections
   2. Capsular Contracture
   3. Implant Rupture
   4. Deformities, Displacement, and Malposition of the Implant
   5. Desmoid Tumors
   6. Breast Implant-Associated Lymphoma
6. Fat Necrosis
7. Silicone Injection
8. Breast Cancer in Patients with Implants
9. Conclusion

Objectives

Upon completion of this course, students will:

1. know the current percentage of saline vs. silicone breast implants
2. recognize the greatest complication for breast implants as they age
3. realize the nature of a breast implant rupture
4. understand why MRI is the imaging modality of choice to evaluate the integrity of breast implants
5. know how current, 5th generation breast implants compare to earlier designs
6. identify the substances used to fill single lumen breast implants
7. recognize characteristics associated with textured implants
8. understand the possible locations for a breast implant in relation to the pectoralis muscle
9. realize that the placement of the implant impacts the ease with which the implant can be displaced for a mammography study
10. learn about signal suppression with MRI pulse sequences
11. identify pulse sequences in a breast MRI exam for a patient who has breast implants
12. recognize proper MR imaging parameters for a breast exam
13. recognize when intravenous gadolinium-based contrast material should be used in a breast MRI exam
14. identify normal findings on breast MR images
15. recognize how to differentiate radial folds from implant rupture on breast MRI
16. know the approximate lifespan of breast implants
17. identify local complications of breast implants
18. learn the MR imaging features suggestive of infection
19. know about capsular contracture
20. understand where free silicone is found with different types of implant rupture
21. register the percentage of breast implants that rupture within 10 years
22. know the term used for saline implants that have leaked
23. recognize the imaging modality with the highest sensitivity for determination of implant rupture
24. realize where silicone may migrate in extracapsular ruptures
25. recognize definitive signs of rupture seen at MRI
26. know the most reliable sign to diagnose extracapsular rupture
27. know another name for desmoid tumor
28. learn about breast implant-associated anaplastic large cell lymphoma
29. recognize a benign inflammatory process that occurs as a result of vascular compromise to adipose tissue
30. understand why mammography is less sensitive to identifying breast cancer in patients with breast implants