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High Resolution > Lesson 3B (Part 1) > Flashcards

Lesson 3B (Part 1) Flashcards

1
Q

Saline breast implants (4)

A
  1. Saline solution
  2. Filled at the time of the surgery
  3. If they rupture they get absorbed
  4. Single lumen
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2
Q

What volume can breast implants be?

A

120-960cc

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3
Q

Silicone breast implants (3)

A
  1. Pre-filled with silicone gel
    - a thick, sticky fluid that closely mimics the feel of human fat
  2. They have a silicone outer shell that is filled with silicone gel
  3. They come in different sizes and have either smooth or textured shells
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4
Q

What is the most common type of breast implant?

A

Saline

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5
Q

Where are the breast implant locations? (2)

A
  1. Subglandular

2. Subpectoral

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6
Q

Subglandular

A

Between glandular tissue and pectoral muscle

- breast augmentation

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7
Q

Subpectoral

A

Between pectoralis major and minor muscles

- breast reconstruction following mastectomy

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8
Q

Which breast implant location is more common for cosmetic purposes?

A

Subglandular

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9
Q

What is the normal appearance of breast implants on US?

A

Radial fold in an implant with normal physiological amount of capsular free fluid

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10
Q

What is a normal finding of an implant?

A

Valve

- high down artifact

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11
Q

How do you image breast implants?

A

2 fold examination

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12
Q

What is the 2 fold examination for breast implant imaging? (2)

A
  1. Breast tissue.
  2. Deeper implant
    - may require lower frequency or a curved probe to investigate
    implant
    - should be anechoic with well defined margins
    - folds are commonly seen in the implant surface
    - small traces of simple fluid will be seen overlying the implant but is contained by the overlying fibrous capsule that contains the implant
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13
Q

What does normal subpectoral prosthesis look like on US?

A

Only the upper part of the implant is covered by the pectoral muscle

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14
Q

What forms around the implant shell after implantation of a silicone or saline breast implant?

A

A fibrous capsule

- scar

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15
Q

What does a ruptured implant look like on US? (2)

A
  1. The implant is empty with multiple folds

2. No anechoic centre

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16
Q

When does an intracapsular rupture occur?

A

When the shell of the implant ruptures but the fibrous capsule formed by the breast remains intact

17
Q

Stepladder sign

A

Indicating that an intracapsular breast implant rupture
- infolding of the wall and free silicone outside the implant
silicone particles in the axilla

18
Q

Linguine sign

A

In an intracapsular rupture the contents of the implant are contained by the fibrous scar, while the shell appears as a group of wavy lines

19
Q

What is another term for stepladder sign on MRI?

A

Linguine sign

20
Q

What can the extracapsular rupture lead to?

A

A change in the implant contour and may be detected on clinical examination or mammography

21
Q

What does an extracapsular rupture imply?

A

An intracapsular rupture as well

22
Q

What does a ruptured silicone prothesis for extracapsular appear like?

A

A snow storm

23
Q

What are implant count irregularities due to?

A

A retraction and encapsulation of fibrous connective tissue

24
Q

What are sonographic findings postsurgical for breast implant imaging? (4)

A
  1. Skin thickening
    - scarring
  2. Architectural distortion of the parenchyma
  3. Development of a mass and/or calcifications
  4. Hypoechoic or hyperechoic structures and/or masses with acoustic shadowing
25
Q

What can postsurgical breast implant images mimic?

A

Cancer

- thus prompting a thorough workup to determine if tissue sampling is indicated to exclude malignancy

26
Q

What is the acute stage of cancer in the breast from implants?

A

Hematomas may be ill defined or may present as a mass containing complex echoes with distal acoustic enhancement or shadowing

27
Q

What happens over time to acute stage cancer in breast implants?

A

The hematoma organizes and becomes more masslike, and the fluid becomes more hypoechoic and may even appear cystic

28
Q

What sonographic finding is consistent with a resolving hematoma after surgery?

A

Complex mass with internal echoes

29
Q

What sonographic finding can be seen in both cancer patients as well as postsurgical scars? (2)

A
  1. Acoustic shadowing

2. Irregular hypoechoic masses

30
Q

What are the sonographic findings in the acute postoperative period?

A

Diffuse hemorrhage and/or edema

  • increase or decrease echogenicity
  • or an area of architectural distortion

High Resolution (37 decks)

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