Gd-DTPA enhanced MR imaging of the breast in patients with postoperative scarring and silicon implants

Sixty patients with postoperative scarring with (30) or without (30) silicon implants have been examined by magnetic resonance (MR) with Gd-diethylenetriamine pentaacetic acid. The 60 patients consisted of 28 patients with obvious normal or abnormal findings and of 32 diagnostically difficult patients, who were referred to MR because of uncertain mammographic and/or clinical findings. Scarring older than 6 months postoperatively did not enhance noticeably, whereas scarring younger than 6 months postoperatively enhanced variably (nonsignificant, borderline, or significant). Since all carcinomas larger than the slice thickness enhance significantly (as also confirmed by other studies) contrast enhanced MR allowed an excellent discrimination between scarring older than 6 months and malignancy. Good visualization of the tissue around silicon implants proved to be another advantage of MR. When its use in the diagnostically difficult cases was analyzed, MR proved quite helpful in 23 of 32 cases by excluding or demonstrating malignancy.