The Efficiency of MR Imaging in Augmented Breasts Post Filler Injection

Abstract

Background: The development of breast augmentation techniques has advanced significantly, with the introduction of various options, including breast implants, which serve different purposes such as mammoplasty, breast reconstruction, and cosmetic breast enhancement. In recent years, injectable fillers have gained popularity as a non-surgical option for breast augmentation. In this context, Magnetic Resonance Imaging (MRI) presents several advantages over traditional imaging techniques like mammography and sonography, particularly in evaluating breasts augmented with injectable fillers. MRI's superior imaging capability makes it an essential tool for diagnosing breast abnormalities in patients who have undergone filler injections. The study aimed to evaluate the efficiency of Magnetic Resonance Imaging (MRI) in diagnosing breast abnormalities in patients who have undergone breast augmentation through filler injections.

Methods: A retrospective pilot study was conducted involving nine subjects who had received breast filler injections. The cohort comprised eight patients from the breast imaging unit at Mubarak Al Kabeer Hospital, a secondary care teaching hospital, and one patient from the Al-Faisal Center in Kuwait utilizing a 1.5 Tesla GE closed MRI machine. The scanning protocol included a series of sequences: T1 Axial, T2 STIR Axial, Axial Diffusion Weighted, Bilateral Sagittal T2, and Axial VIBRANT. Additionally, dynamic gadolinium-enhanced imaging was performed in seven phases. Subtracted images, Maximum Intensity Projection (MIP), kinetic curves, and color maps were also generated as part of the comprehensive imaging process.

Results: MRI scans revealed multiple well-defined masses of varying sizes in both breasts, often accompanied by skin thickening and edema. The imaging characteristics included iso to hypointense signals on T1-weighted images, hyperintense signals on T2-weighted images, and intermediate to low signals on VIBRANT sequences. Importantly, these masses showed no enhancement with contrast and no restricted diffusion, suggesting a benign nature. One patient presented with a small cyst, while another displayed a well-defined, lobulated, heterogeneously enhancing mass, which was confirmed to be an atypical fibroadenoma upon core biopsy.

Conclusions: The study concluded that MRI is the optimal imaging modality for evaluating breast lumps in patients with a history of filler injections, providing clear and definitive imaging results that can differentiate injected materials from other breast masses and highlight the need for continued research to refine diagnostic approaches in this growing area of cosmetic procedures and reconstructive breast procedures.