title: Capsular contracture and possible implant rupture: is magnetic resonance imaging useful?
abstract: BACKGROUND
  Currently, magnetic resonance imaging is considered the accepted standard to evaluate breast implant integrity.
  
  
  METHODS
  To evaluate its utility in diagnosing ruptured silicone implants in the setting of capsular contracture and to correlate the preoperative assessment of implant integrity with or without magnetic resonance imaging with operative findings, 319 capsulectomies (171 patients with capsular contractures) were retrospectively reviewed. Preoperative magnetic resonance imaging was done on 160 implants, whereas the remaining 159 were evaluated using only physical examination and/or mammography. Postoperative results were analyzed to determine the sensitivity, specificity, and accuracy of preoperative magnetic resonance imaging in comparison with clinical and/or mammography evaluation alone.
  
  
  RESULTS
  Although occasionally valuable, overall, preoperative magnetic resonance imaging was no more accurate than clinical evaluation with or without mammography in predicting implant status: magnetic resonance imaging 124 of 160 (78 percent) and clinical 121 of 159 (76 percent; p = 0.77).
  
  
  CONCLUSIONS
  In the setting of capsular contracture, physical examination with or without mammogram is as accurate as magnetic resonance imaging in determining implant integrity. Although magnetic resonance imaging is a sensitive diagnostic tool, in symptomatic patients with capsular contracture, it cannot be viewed as infallible.
authors.affiliation: Department of Surgery, Section of Plastic and Reconstructive Surgery, Mayo Clinic Jacksonville, 4500 San Pablo RoadJacksonville, FL 32224, USA.
authors.forename: Alyssa A
authors.initials: AA
authors.lastname: Paetau
authors.forename: Sarah A
authors.initials: SA
authors.lastname: McLaughlin
authors.forename: Rebecca B
authors.initials: RB
authors.lastname: McNeil
authors.forename: Erez
authors.initials: E
authors.lastname: Sternberg
authors.forename: Sarvam P
authors.initials: SP
authors.lastname: TerKonda
authors.forename: James C
authors.initials: JC
authors.lastname: Waldorf
authors.forename: Galen
authors.initials: G
authors.lastname: Perdikis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018427:Breast Implants; D003286:Contracture / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011475:Prosthesis Failure; D012189:Retrospective Studies; D012421:Rupture