Accuracy of ultrasonography and magnetic resonance imaging in detecting failure of breast implants filled with silicone gel

We prospectively studied the accuracy of magnetic resonance imaging (MRI) a nd ultrasonography (US) for preoperative detection of rupture in 35 single- lumen implants filled with silicone gel in 18 patients. The positive predic tive value of US for rupture of an implant was 70% and the negative predict ive value 64%. Sensitivity and specificity were 44% and 87%, respectively. Accuracy, defined as the total true positive and true negative values divid ed by the total number of implants studied was 66%. The positive predictive value of MRI was 100% and the negative predictive value 90%. The correspon ding sensitivity and specificity were 88% and 100% and the accuracy 94%. MR I offers significantly better diagnostic sensitivity (p = 0.02) and accurac y (p = 0.004), and should be regarded as the "gold standard" in the evaluat ion of rupture of breast implants filled with silicone gel. When MRI is not readily available, US is an acceptable alternative.