Silicone gel-filled breast implants in women: findings at H-1 MR spectroscopy.
OBJECTIVE
To evaluate, at hydrogen-1 magnetic resonance (MR) spectroscopy, the effect of implantation time, implant status, and implant removal on the amount of silicone in the liver in women with silicone gel-filled breast prostheses.


METHODS
The study population included 55 women (39 patients with silicone gel-filled prostheses and seven from whom implants had been removed, and nine control subjects [eight with no implant and one with saline-filled implants]). Stimulated-echo acquisition mode, or STEAM, H-1 MR spectroscopy was performed to determine the concentration of silicone in the liver. Implant status at the time of spectroscopy was diagnosed at MR imaging.


RESULTS
Twenty of 39 (51%) women with implants had ruptured prostheses. Resonances associated with the presence of silicone and partially hydrolyzed silicone (0.3 to -0.8 ppm with respect to water at 4.7 ppm) and other resonances that are not yet assigned (-2 to -5 ppm) were detected in 27 (69%) of the 39 women (17 with ruptured implants). Relative signal intensities of the silicone species detected in the liver in these women were found to vary substantially and were not correlated with the status of the implants (P > .70). Silicone resonances were not detected in the livers in the nine control subjects. After implant removal, no resonances between 0.3 and -0.8 ppm were observed in six of seven women, but silicone-related peaks were still detectable in the region of -2 to -5 ppm.


CONCLUSIONS
Proton MR spectra obtained in the liver of women with silicone gel-filled breast implants helped measure silicone exposure.
Pfleiderer
B
B
Department of Radiology, Massachusetts General Hospital, Charlestown 02129, USA.
Campbell
T
T
Hulka
C A
CA
Kopans
D B
DB
Lean
C L
CL
Ackerman
J L
JL
Brady
T J
TJ
Garrido
L
L
D000328:Adult; D000368:Aged; D018427:Breast Implants; D005260:Female; D006801:Humans; D006859:Hydrogen; D008099:Liver / Q000737:chemistry* / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation; D012828:Silicones / Q000032:analysis* / Q000493:pharmacokinetics; D013997:Time Factors
D012828:Silicones; D006859:Hydrogen