DIAGNOSIS OF BREAST IMPLANT RUPTURE - IMAGING FINDINGS AND RELATIVE EFFICACIES OF IMAGING TECHNIQUES

OBJECTIVE.The purpose of this study was to compare the efficacies of m ammography, sonography, CT, and MR imaging in the detection of breast implant rupture and to analyze the imaging findings, SUBJECTS AND METH ODS. Thirty-two women with 63 silicone breast implants participated in the study. All but one had signs and symptoms suggestive of rupture, and all had requested that their implants be removed before they were enrolled in this imaging study. All patients had film-screen mammograp hy, sonography, CT, and MR imaging. Twenty-two ruptures were found at surgery; 21 were intracapsular and one was extracapsular, The relative efficacies of the imaging studies were determined, and the imaging fi ndings were compared with the surgical results. RESULTS. Of the 32 wom en with 63 implants, mammographic sensitivity for detecting implant ru pture was only 23% but the specificity was 98%, Sonography had a highe r sensitivity (59%), but its specificity was significantly lower (79%) , CT had a sensitivity of 82% and a specificity of 88%. MR was the onl y imaging technique that consistently provided evidence that enabled t he evaluation of intracapsular and extracapsular ruptures. The sensiti vity and specificity of MR imaging were 95% and 93%, respectively. CON CLUSION. Our results show that MR imaging is more sensitive and specif ic for the detection of breast implant rupture than is mammography, CT , or sonography,