0:00

So what I'm going to do while those are loading,

0:02

is I'm going to show you a fun case that I have

0:06

just on the PowerPoint series and that went with the implants.

0:11

This is a patient who is 80-odd woman.

0:17

She's status post left mastectomy, and she had a saline implant

0:21

put in and then has new deformity of her left breast site

0:26

as you can see here.

0:27

And so these are T2 fat suppressed images.

0:31

I'm just going to talk you through this.

0:32

And you can see that with a saline implant,

0:34

which you certainly do not need any imaging to diagnose.

0:37

Everything just collapses into a big hole.

0:39

So if you want to know what linguine sign is for silicon, it looks like this.

0:43

Only with silicon rather than the T2 bright.

0:46

As part of this study, she also was fat...

0:51

We gave gadolinium. I don't know why they gave gadolinium as an outside study.

0:53

They just didn't know what was going on with her,

0:55

and they wanted to sort of look at the implant, but look for recurrence.

1:00

They found an occult 1cm enhancing mass

1:05

on the gadolinium.

1:07

And here it is on the ultrasound.

1:10

And obviously, this is a sort of classical

1:12

malignancy with a spiculated borders hypoechoic shadowing,

1:17

and this echogenic halo.

1:18

And this was an invasive ductal carcinoma recurrence in this patient.