mrimaster

MRI Breast Implants

Indications for breast implant MRI scans

Contraindications

Patient preparation for breast implant MRI scan

Positioning for breast implant MRI scans

MRI breast implant protocol positioning photo

Recommended Breast Implant MRI Protocols and Planning

Breast implant MRI localiser

A three-plane localizer must be taken to plan the sequences. Localizers are normally less than 25 seconds and consist of T1-weighted low-resolution scans.

T2 SPACE 3D axial 1MM

Plan the axial slices on the sagittal plane and align the position block parallel to the breast. Verify the positioning block in the other two planes. Ensure an appropriate angle is set in the coronal plane, parallel to the right and left nipples. The slices should be sufficient to cover the entire breast. To prevent wrap-around artifacts, oversampling of both the slice and phase should be applied. Phase direction in the axial scans must be right to left, this is to avoid the artefacts from chest and heart motion.

If 3D sequences are unavailable on your scanner, please utilize 2D T2 axial scans with a slice thickness of 2 to 3mm.

Parameters T2 SPACE 3D

TR

1500-2000

TE

94

FLIP

170

NXA

1.4

SLICE

1.5 MM

MATRIX

320X256

FOV

350-390

PHASE

R>L

GAP

10%

OVERSAMPLE

10%  and 20%

T1 flash 3D axial non fat sat 1mm

Plan the axial slices on the sagittal plane and align the position block parallel to the breast. Verify the positioning block in the other two planes. Ensure an appropriate angle is set in the coronal plane, parallel to the right and left nipples. The slices should be sufficient to cover the entire breast. To prevent wrap-around artifacts, oversampling of both the slice and phase should be applied. Phase direction in the axial scans must be right to left, this is to avoid the artefacts from chest and heart motion.

Parameters

TR

6-7

TE

3-4

FLIP

20

NEX

1

SLICE

1MM

MATRIX

384X320

FOV

350

PHASE

R>L

OVERSAMPLE

30%

IPAT

ON

T2 stir TI 130 coronal

Plan the coronal slices on the axial plane and position the block perpendicular to the right and left breast. Verify the positioning block in the other two planes. Ensure an appropriate angle is set in the sagittal plane, perpendicular to the right and left breast. The slices should adequately cover the entire breast from the nipple to the axilla. In axial scans, the phase direction should be from right to left to avoid artifacts caused by motion from the chest and heart.

Parameters

TR

4000-5000

TE

110

FLIP

150

NEX

2

SLICE

3 MM

MATRIX

320X320

FOV

350-390

PHASE

R>L

WATER SAT

OFF

TI

130

T2 STIR with water suppression axial

Plan the axial slices on the sagittal plane and align the position block parallel to the breast. Verify the positioning block in the other two planes. Ensure an appropriate angle is set in the coronal plane, parallel to the right and left nipples. The slices should be sufficient to cover the entire breast. To prevent wrap-around artifacts, oversampling of both the slice and phase should be applied. Phase direction in the axial scans must be right to left, this is to avoid the artefacts from chest and heart motion.

Parameters

TR

4000-5000

TE

110

FLIP

130

NEX

2

SLICE

3 MM

MATRIX

320X320

FOV

350-390

PHASE

R>L

WATER SAT

ON

TI

130

In case you are operating a Siemens scanner, ensure that both STIR and water saturation are activated for this particular sequence.

T2 stir TI 450 or STIR silicon sat axial

Plan the axial slices on the sagittal plane and align the position block parallel to the breast. Verify the positioning block in the other two planes. Ensure an appropriate angle is set in the coronal plane, parallel to the right and left nipples. The slices should be sufficient to cover the entire breast. To prevent wrap-around artifacts, oversampling of both the slice and phase should be applied. Phase direction in the axial scans must be right to left, this is to avoid the artefacts from chest and heart motion.

Parameters

TR

4000-5000

TE

110

FLIP

130

NEX

2

SLICE

3 MM

MATRIX

320X320

FOV

350-390

PHASE

R>L

GAP

10%

TI

450

Why two different TIs ?

TI 450 is used to suppress the signals form silicon where us TI 130 is used to suppress the signals from fat.

If you choose the Silicon saturation sequence with the silicon sat pulse, please adhere to the following instructions.

Silicon Saturation pulse

In MRI (Magnetic Resonance Imaging), a Fat-Saturation (Fat-Sat) pulse is a short-duration radiofrequency (RF) pulse that is specifically tuned to the resonance frequency of fat molecules. This pulse is applied just before starting an MR imaging sequence. The primary purpose of the Fat-Sat pulse is to selectively nullify or ‘saturate’ the signal from fat molecules while leaving the signal from water and other tissues relatively unaffected.

When the Silicon Saturation pulse option is activated in the sequence, the MRI scanner will display a graph during the frequency adjustment process. The graph will show three distinct peaks in SIEMENS MRI scanners: the first peak corresponds to silicon, the second to fat, and the third to water. The appearance of the graph might vary in scanners from other manufacturers.

The user then needs to select the appropriate peak for suppressing the silicon signal. Once the appropriate peak is chosen, the sequence will suppress the silicon signal, causing silicon to appear dark in the resulting image. Please refer to the picture below for an example of the graph displayed on SIEMENS scanners.

Breat Silicone Confirm Frequency adjestment graph MRI

T1 flash axial 3D fat sat dynamic 1 pre and 5 post

Plan the axial slices on the sagittal plane and align the position block parallel to the breast. Verify the positioning block in the other two planes. Ensure an appropriate angle is set in the coronal plane, parallel to the right and left nipples. The slices should be sufficient to cover the entire breast. To prevent wrap-around artifacts, oversampling of both the slice and phase should be applied. Phase direction in the axial scans must be right to left, this is to avoid the artefacts from chest and heart motion.

A dynamic flash 3D fat saturation sequence comprises six flash 1mm 3D scans with a 10-second delay between the first and second scans. The first scan in the dynamic sequence serves as a pre-contrast scan, which is utilized as a subtraction mask for the post-contrast scans. The second through sixth scans are considered post-contrast scans. According to the manufacturer’s instructions and departmental policy, a gadolinium-based contrast agent should be injected at a dose of 0.2ml/kg between the first and second scans, specifically during the 10-second delay period.

Parameters

TR

4-5

TE

2

FLIP

12

NEX

1

SLICE

1 MM

MATRIX

448X320

FOV

350-380

PHASE

R>L

DYNAMIC

6 SCANS

IPAT

ON

T1 flash 3D fat sat post contrast 1mm

Plan the coronal slices on the axial plane and position the block perpendicular to the right and left breast. Verify the positioning block in the other two planes. Ensure an appropriate angle is set in the sagittal plane, perpendicular to the right and left breast. The slices should adequately cover the entire breast from the nipple to the axilla. In axial scans, the phase direction should be from right to left to avoid artifacts caused by motion from the chest and heart.

Parameters

TR 4-5

TE

2

FLIP

12

NEX

2

SLICE

1MM

MATRIX

512X512

FOV

350-360

PHASE

R>L

OVERSAMPLE

30%

IPAT

ON

DWI zoomit \ epi 3 scan trace axial

Plan the axial slices on the sagittal plane and align the position block parallel to the breast. Verify the positioning block in the other two planes. Ensure an appropriate angle is set in the coronal plane, parallel to the right and left nipples. The slices should be sufficient to cover the entire breast. For axial DWI zoomit scans, the phase direction should be from anterior to posterior. This helps avoid artifacts caused by the air-tissue interface by minimizing unwanted areas within the field of view (FOV). To mitigate wrap-around and motion artifacts originating from the chest and heart, it is recommended to apply two saturation bands over the chest region.

Parameters EPI DWI

TR

5000-6000

TE

90

IPAT

ON

NEX

4

SLICE

4MM

MATRIX

192X192

FOV

320-360

PHASE

R>L

GAP

10%

B VALUE

0          
500
1400

Zoomit DWI

Zoomit DWI is an advanced MRI imaging technique that leverages Siemens’ TimTX TrueShape platform and the application called Syngo ZOOMit. TimTX TrueShape introduces a new transmit platform with two independent transmitters, enabling flexible switching of RF waveforms and gradient shapes. This dynamic parallel transmission (pTX) capability opens up new possibilities for imaging applications.

Syngo ZOOMit, the first application based on TimTX TrueShape, utilizes the concept of “zooming” in MR imaging. Similar to optical zoom in a camera, ZOOMit allows for exciting a smaller field-of-view (FOV) than the object in the phase-encoding direction, thereby avoiding aliasing artifacts. By reducing the FOV, fewer phase-encoding lines are required, leading to faster scan times, improved spatial resolution in the region of interest, and reduced motion and flow artifacts.

Zoomit DWI offers several advantages over conventional DWI techniques. It employs multiple parallel radiofrequency pulse sequences simultaneously, capturing high signal specifically from the area of interest. This approach reduces folding artifacts, provides better anatomical detail, decreases distortion and blurring, and improves overall image quality. Additionally, it allows for faster screening, increased spatial resolution, and minimized susceptibility artifacts and geometric distortions.

With ZOOMit, radiologists and researchers can selectively image the volume of interest, achieve faster and higher-resolution imaging, enhance diagnostic confidence by detecting and evaluating smaller lesions in challenging areas, and broaden the scope of clinical MR imaging.

ZOOMit DWI breast images