MRI Breast — implant integrity (unenhanced)
Both breasts including the full anteroposterior extent of the implants and the axillary tail, prone in a breast coil.
Typical, not policy
Timings, volumes and delays here are representative values drawn from published guidance. Scanner generation, injector, cardiac output and local preference all move them. Confirm against your department's own protocol before you rely on a number.
When to use it
- Suspected silicone implant rupture, particularly where ultrasound is equivocal.
- Surveillance of silicone implants where a local or manufacturer protocol specifies periodic imaging.
- New breast asymmetry, pain or contour change in a woman with implants.
- Assessment of extracapsular silicone and silicone lymphadenopathy.
Technique
- Silicone-only (water-suppressed) and water-only (silicone-suppressed) sequences in at least two planes, plus T2 for the fibrous capsule and any fluid collection.
- Thin sections through the implant so that a collapsed shell can be traced.
- The implant type and the number of implants should be known in advance; saline and silicone implants need different sequence choices.
Where it goes wrong
- Giving gadolinium for an integrity question, which adds nothing and exposes the patient unnecessarily.
- Omitting the silicone-selective sequence, without which extracapsular silicone can be missed entirely.
- Thick slices averaging out a collapsed shell.
- Not knowing the implant type or the presence of a double lumen, leading to misinterpretation of normal internal structure.
Clinical questions that reach this study
Contrast
None
- No gadolinium. The question is silicone integrity, answered entirely by silicone-selective and water-suppressed sequences.
Acquisition
- Breathing
- Free breathing.
- Preparation
- In premenopausal women, background parenchymal enhancement is lowest in the second week of the cycle; scheduling around day 7-14 is conventional where the question allows waiting. Give the date of any biopsy, surgery or radiotherapy — post-treatment enhancement is a scheduling problem, not just a reporting one. An implant-integrity question needs no gadolinium at all; separate it from an oncological question on the request.
Safety checks this protocol carries
Derived from the contrast agent and phases above, not authored here — which is why they cannot drift apart from what the protocol actually does.
- Prior contrast reaction and elective premedication· nurse pre scan
- Kidney function and gadolinium-based contrast· radiographer at scan
- Intravenous access adequate for the planned injection· radiographer at scan
- MR safety screening for implants and foreign bodies· radiographer at scan
- Gadolinium in known or possible pregnancy· radiographer at scan