title: Diagnosing breast implant rupture with MR imaging, US, and mammography.
abstract: 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.
authors.affiliation: Russell P. Morgan Department of Radiology and Radiological Services, Johns Hopkins Medical Institutions, Baltimore, MD 21287.
authors.forename: W A
authors.initials: WA
authors.lastname: Berg
authors.forename: C I
authors.initials: CI
authors.lastname: Caskey
authors.forename: U M
authors.initials: UM
authors.lastname: Hamper
authors.forename: N D
authors.initials: ND
authors.lastname: Anderson
authors.forename: B W
authors.initials: BW
authors.lastname: Chang
authors.forename: S
authors.initials: S
authors.lastname: Sheth
authors.forename: E A
authors.initials: EA
authors.lastname: Zerhouni
authors.forename: J E
authors.initials: JE
authors.lastname: Kuhlman
mesh_terms: 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
chemical_list: D012828:Silicones