Which findings are characteristic of hematomas and seromas on magnetic resonance mammography (breast MRI) following surgery?

Updated: Feb 25, 2019
  • Author: Preeti Gupta, MD, FRCR; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

Hematomas and seromas are usually seen shortly after surgery. However, in some cases, they may persist for months or years. Seromas appear as fluid-intensity, nonenhancing masses with smooth margins. Hematomas may be hyperintense or hypointense on T1W images, depending on the age and oxygenation state of the blood products. Chronic hematomas may have a low-intensity hemosiderin rim.

Both may show a rim of enhancing granulation tissue. This enhancement may be intense, potentially masking residual malignancy at the boundary of the collection. Focal nodular rim enhancement raises suspicion of residual disease. This reactive postsurgical enhancement decreases over time. A delay of at least 28 days after surgery is needed to achieve a reasonable specificity (75%) and an NPV (86%) for the detection of residual tumor. [70]


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