RUPTURED OR INTACT - WHAT CAN LINEAR ECHOES WITHIN SILICONE BREAST IMPLANTS TELL US

OBJECTIVE, During sonographic evaluation of silicone breast implants f or possible rupture, we have frequently encountered several patterns o f linear echoes within the implants, To our knowledge, the significanc e of this finding has not been established in the literature. The purp ose of this study was to determine whether internal echoes are signifi cant in predicting implant rupture. SUBJECTS AND METHODS. Thirty-three patients with 64 silicone implants were prospectively entered into a study that included gray-scale sonography of the implants and subseque nt surgical removal, Echo patterns within the implants were retrospect ively evaluated on hard-copy films and compared with the integrity of the implant at surgery. RESULTS, Three categories of internal echo pat terns were identified: ''thick linear echoes,'' ''thin linear echoes,' ' and ''commas.'' One or more of these echo patterns were seen in 57 ( 89%) of the 64 implants, Thick linear echoes were seen in 23 (36%) of the 64 implants, thin linear echoes were seen in 33 (52%) of the 61 im plants, and commas were seen in 47 (73%) of the 64 implants, All echo patterns were seen in intact and ruptured implants with nearly equal f requency. We found no statistical significance for any echo pattern in predicting whether an implant was ruptured or intact. Of the 64 impla nts, four were entirely free of internal echoes. All four implants wer e intact. CONCLUSION, A variety of linear echoes can be seen in most s ilicone breast implants on gray-scale sonography. The presence or abse nce of linear echoes is not useful in predicting implant rupture. Comp lete absence of internal echoes, while highly predictive of an intact implant, is infrequently seen.