Diagnosing breast implant rupture with MR imaging, US, and mammography.
A total of 135 symptomatic women with 262 breast implants were examined with magnetic resonance (MR) imaging performed with a body coil, ultrasound (US), or both to determine imaging features of implant rupture. Surgical proof was available for 33 women with 62 implants; 24 were ruptured and 38 were intact. Complicated internal structure was the most reliable predictor of implant rupture: Diffuse low-level echoes were seen on sonograms in 56% of ruptured implants; internal membranes (which correspond to the collapsed implant shell) were seen on MR images in 58% of ruptured implants. Fluid droplets were seen within the silicone in 26% of ruptured implants on MR images. Irregular implant contour can be a sign of rupture but is unreliable. Fluid collections around silicone implants are not a sign of rupture. At present, neither US nor conventional MR imaging with a body coil is sufficiently reliable to advocate routine screening of asymptomatic women with breast implants. Evaluation with MR imaging performed with a surface coil is more reliable.
Berg
W A
WA
Russell P. Morgan Department of Radiology and Radiological Services, Johns Hopkins Medical Institutions, Baltimore, MD 21287.
Caskey
C I
CI
Hamper
U M
UM
Anderson
N D
ND
Chang
B W
BW
Sheth
S
S
Zerhouni
E A
EA
Kuhlman
J E
JE
D001940:Breast / Q000473:pathology; D004868:Equipment Failure; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D016462:Mammaplasty; D008327:Mammography; D019736:Prostheses and Implants / Q000009:adverse effects*; D012680:Sensitivity and Specificity; D012828:Silicones; D013997:Time Factors; D016217:Ultrasonography, Mammary
D012828:Silicones