0:01

So MRI is very sensitive and specific to evaluate the silicon

0:05

implant, uh, integrity.

0:09

And what are the MRI technique we used to evaluate, uh, implant.

0:14

So we definitely need the dedicated breast, coil and magnetic felt,

0:19

felt, need to be a more than 1.5 per Tesla. And remember,

0:23

no IV contrast. It's different from the, uh, typical mri,

0:29

uh, screening or preop evaluation.

0:32

They will also need aster and T2 sequences to either enhance,

0:36

also press the signal intensity from implant or water for the

0:41

silicone test selective imaging.

0:44

The silicone will be bright and the water will be dark on the contrary for the

0:49

silicone on the silicone saturated imaging.

0:52

And the water will be bright and the silicone will be dark other than the, uh,

0:56

two sequences to, uh, ether and cancer, and also suppress the, uh,

1:01

silicone and water signal intensity. We also need, uh, two different plans.

1:06

One is the axial plant, one is the SAG plant.

1:11

Here are the imaging examples for implant, uh, evaluations. On I,

1:16

here's the thorough imaging or silicone bright.

1:20

You can see that the silicone are very bright.

1:22

And this is a silicone saturate imaging silicone or dark.

1:28

And this is a TT weight imaging. And then this is a, such the imaging over here

1:35

and the is bright question,

1:39

what's the most reliable MRI sign of Intracapsular Raptor?

1:46

All right, this is great. You guys all get it right. Again,

1:50

the ingredient sign is the, uh, correct answer.

1:54

And the ingredient sign is for MRI

1:59

stepladder is for the, uh, um, ultrasound.

2:03

So for the intracapsular rupture in the, it can keyhole,

2:07

it can have show as a keyhole sign or subcapsular line at the early

2:12

stage and the later eye, it can present as a ingredient sign on the r i.

2:17

And intracapsular ruptures is more common than the, uh,

2:21

extracap rupture. This is how it look.

2:24

One of the examples of the intracapsular rupture. And then the,

2:29

the capsule over here actually is still intact over there.

2:34

Um, here is the, uh, uh, radio fold, which is normal.

2:39

You can see it. Um, the, uh, sagittal view at the beginning.

2:44

You may think about to just, if you just look at the axial imaging,

2:48

you may think, Hey,

2:49

that could be acapture and present as

2:55

AVO capsule line. So always look at the sag

2:58

To, uh, as you cross reference. Um,

3:03

here are the actual capsule rupture sign. You don't need.

3:07

Remember what is name of the signs. You can tell if this jail, you know,

3:11

silicone jail come out of this capsule. Like, is this one or this a Saturn?

3:15

You have no problem to call it. And there's another one is more dramatic.

3:20

Lot of deals just came out of this, uh, implant capsule.

3:25

And, uh, remember that, um,

3:28

sometimes you can see this granuloma. Um,

3:31

the m r i with contrast in silicon con granuloma can enhance

3:36

just like the, uh, breast cancer, like in this case over here.

3:41

Okay, another question.

3:44

Breast expander is a contraindication to mri. What's the

3:48

Least likely reason?

3:53

All right, all you guys got

3:55

It right? Yes. Review the breast, uh, expander.

4:00

Breast expander is a device, uh,

4:03

certainly used to place the,

4:06

in the mastectomy bed to stretch the offline skin.

4:10

It's often used though for the patient with cancer and then have

4:15

the, um, uh, mastectomy, right?

4:18

It has a metallic port and also magnetic markers. We use.

4:23

They use that, uh,

4:24

for needle localization and access for sequential ceiling injections

4:30

so that they can gradually and stretch the, uh, offline skin.

4:35

And it is contraindicated to M R I because, uh, uh,

4:39

the metallic port can generate overheating and, uh,

4:43

the tissue is pander, can be displaced,

4:46

and also the marker can be demagnetized. And later on you cannot, uh,

4:51

use that.