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Diagnostic value and safety of dynamic MRI of contralateral breast and axilla in subjects with tissue expander
Authors:Alfonso Fausto  Marco Bernini  Letizia Di Giacomo  Vivian Schivartche  Marco Marcasciano  Donato Casella  Luca Volterrani  Maria Antonietta Mazzei
Affiliation:1. Department of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, University Hospital of Siena, Viale Bracci 16, 53100 Siena, Italy;2. Breast Unit, Department of Surgery, Careggi University Hospital, Largo Brambilla 3, 50134 Firenze, Italy;3. Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging, University of Siena, Strada delle Scotte 2, 53100 Siena, Italy;4. Department of Breast Imaging, CDB Premium, Av Brazil, 1193 Sao Paulo, SP, Brazil.;5. Breast Unit, Department of Surgery, Azienda U.S.L. Toscana Nord-Ovest, Hospital of Livorno, Via Vittorio Alfieri 36, 57124 Livorno, Italy;6. Department of Surgery “Valdoni”, Unit of Plastic Reconstructive and Aesthetic Surgery, Policlinico Umberto I – “Sapienza” University of Rome, Viale del Policlinico, 155, 00161 Roma, Italy
Abstract:

Introduction

To verify the diagnostic value of contrast-enhanced breast and axillary MRI in patients with tissue expander labeled as “MR-unsafe” and to confirm its safety.

Patients and methods

Breast MRI examinations performed in patients with tissue expander in the period from August 2010 to December 2017 were reviewed after IRB approval. In the case of breast lesion or lymph node, breast MRI exams after definitive prosthetic replacement were used for comparison. Breast MRI was performed using 1.5 T equipment with a dedicated coil. The protocol included axial STIR sequence and axial dynamic sequence with fat suppression (1 pre-contrast and 4 post-contrast phases). Two radiologists experienced in breast imaging reviewed images using six parameters for image quality evaluation. t-Test for dependent samples, Wilcoxon and Sign test were used.

Results

Twenty-three patients (49?±?9 years, range 34–68 years) with tissue expander who underwent contrast-enhanced MRI were reviewed. Thirteen breast lesions (12.92?±?4.84?mm) and eleven lymph nodes (11.00?±?4.29?mm) were found. In breast MRI examinations used for comparison no significant difference was observed in breast lesions (12.69?±?4.71?mm, P?=?0.707) or lymph node dimensions (10.58?±?3.00?mm, P?=?0.538). No significant difference was observed in lesion classification. A significantly lower visibility was observed for vascular maps (P?

Conclusion

When necessary, after adequate information and preparation, contrast-enhanced breast MRI can be performed in patients with tissue expanders maintaining its diagnostic value and safety.
Keywords:MRI  Magnetic resonance imaging  MRI safety  Tissue expander  Breast tissue expander  Expander
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