title: Poly Implant Prothèse (PIP) incidence of rupture: a retrospective MR analysis in 64 patients.
abstract: OBJECTIVE
  The purpose of this retrospective study was to describe the magnetic resonance imaging (MRI) features of Poly Implant Prothèse (PIP) hydrogel implants in a group of 64 patients and to assess the incidence of rupture, compared to other clinical trials.
  
  
  METHODS
  In this double-center study, we retrospectively reviewed the data sets of 64 consecutive patients (mean age, 43±9 years, age range, 27-65 years), who underwent breast MRI examinations, between January 2008 and October 2013, with suspected implant rupture on the basis of clinical assessment or after conventional imaging examination (either mammography or ultrasound). All patients had undergone breast operation with bilateral textured cohesive gel PIP implant insertion for aesthetic reasons. The mean time after operation was 8 years (range, 6-14 years). No patients reported history of direct trauma to their implants.
  
  
  RESULTS
  At the time of clinical examination, 41 patients were asymptomatic, 16 complained of breast tenderness and 7 had clinical evidence of rupture. Normal findings were observed in 15 patients. In 26 patients there were signs of mild collapse, with associated not significant peri-capsular fluid collections and no evidence of implant rupture; in 23 patients there was suggestion of implant rupture, according to breast MRI leading to an indication for surgery. In particular, 14 patients showed intra-capsular rupture, with associated evidence of the linguine sign in all cases; the keyhole sign and the droplet signs were observed in 6 cases. In 9 patients there was evidence of extra-capsular rupture, with presence of axillary collections (siliconomas) in 7 cases and peri-prosthetic and mediastinal cavity siliconomas, in 5 cases.
  
  
  CONCLUSIONS
  The results of this double center retrospective study, confirm the higher incidence (36%) of prosthesis rupture observed with the PIP implants, compared to other breast implants.
authors.affiliation: 1 Department of Radiology, University "Federico II", Napoli, Italy ; 2 Department of Radiology, Ospedale S.M.delle Grazie, Pozzuoli, Napoli, Italy ; 3 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Napoli, Italy.
authors.forename: Mariella
authors.initials: M
authors.lastname: Scotto di Santolo
authors.affiliation: 1 Department of Radiology, University "Federico II", Napoli, Italy ; 2 Department of Radiology, Ospedale S.M.delle Grazie, Pozzuoli, Napoli, Italy ; 3 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Napoli, Italy.
authors.forename: Bianca
authors.initials: B
authors.lastname: Cusati
authors.affiliation: 1 Department of Radiology, University "Federico II", Napoli, Italy ; 2 Department of Radiology, Ospedale S.M.delle Grazie, Pozzuoli, Napoli, Italy ; 3 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Napoli, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Ragozzino
authors.affiliation: 1 Department of Radiology, University "Federico II", Napoli, Italy ; 2 Department of Radiology, Ospedale S.M.delle Grazie, Pozzuoli, Napoli, Italy ; 3 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Napoli, Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Dell'Aprovitola
authors.affiliation: 1 Department of Radiology, University "Federico II", Napoli, Italy ; 2 Department of Radiology, Ospedale S.M.delle Grazie, Pozzuoli, Napoli, Italy ; 3 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Napoli, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Acquaviva
authors.affiliation: 1 Department of Radiology, University "Federico II", Napoli, Italy ; 2 Department of Radiology, Ospedale S.M.delle Grazie, Pozzuoli, Napoli, Italy ; 3 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Napoli, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Altiero
authors.affiliation: 1 Department of Radiology, University "Federico II", Napoli, Italy ; 2 Department of Radiology, Ospedale S.M.delle Grazie, Pozzuoli, Napoli, Italy ; 3 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Napoli, Italy.
authors.forename: Antonello
authors.initials: A
authors.lastname: Accurso
authors.affiliation: 1 Department of Radiology, University "Federico II", Napoli, Italy ; 2 Department of Radiology, Ospedale S.M.delle Grazie, Pozzuoli, Napoli, Italy ; 3 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Napoli, Italy.
authors.forename: Albina
authors.initials: A
authors.lastname: Riccardi
authors.affiliation: 1 Department of Radiology, University "Federico II", Napoli, Italy ; 2 Department of Radiology, Ospedale S.M.delle Grazie, Pozzuoli, Napoli, Italy ; 3 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Napoli, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Imbriaco
keywords: Poly Implant Prothèse (PIP) implants; breast augmentation; implant rupture; magnetic resonance imaging (MRI)