Silicone breast implants: US evaluation.
OBJECTIVE
To determine the value of breast ultrasonography (US) in the assessment of silicone breast implants for rupture.


METHODS
Seventy-four women with local or systemic symptoms related to silicone implants underwent breast US. Of these, 28 underwent surgical removal of the implants.


RESULTS
Of 57 implants removed, 37 were intact. The most reliable sign of an intact implant was an anechoic interior, although reverberation artifact and radical folds could be seen. Of 20 ruptured implants, 16 were intracapsular and four were extracapsular ruptures. The most reliable US sign of rupture was echogenic, horizontal ("stepladder") lines (14 of 20 ruptures). Two of the four extracapsular ruptures were accurately identified as echogenic nodules outside the implant; two were false-negative findings. Three intracapsular ruptures identified at US were false-positive; six were false-negative. Overall sensitivity for rupture was 70%, specificity was 92%, positive predictive value was 82%, and negative predictive value was 85%.


CONCLUSIONS
Breast US is capable of depicting intracapsular and extracapsular rupture of breast implants.
DeBruhl
N D
ND
Iris Cantor Center for Breast Imaging, Department of Radiological Sciences, UCLA Medical Center 90024-6952.
Gorczyca
D P
DP
Ahn
C Y
CY
Shaw
W W
WW
Bassett
L W
LW
D000328:Adult; D000368:Aged; D001940:Breast / Q000601:surgery; D004868:Equipment Failure; D005260:Female; D006801:Humans; D016462:Mammaplasty; D008875:Middle Aged; D019736:Prostheses and Implants; D012680:Sensitivity and Specificity; D012828:Silicones; D013499:Surface Properties; D016217:Ultrasonography, Mammary / Q000295:instrumentation / Q000379:methods
D012828:Silicones