INTRACAPSULAR IMPLANT RUPTURE - MR FINDINGS OF INCOMPLETE SHELL COLLAPSE

The objective of this study was to determine the frequency and signifi cance of the MR findings of incomplete shell collapse for detecting im plant rupture in a series of surgically removed breast prostheses, MR images of 86 breast implants in 44 patients were studied retrospective ly and correlated with surgical findings at explantation. MR findings Included (a) complete shell collapse (linguine sign], 21 implants; (b) incomplete shell collapse (subcapsular line sign, teardrop sign, and keyhole sign), 33 implants; [c) radial folds, 31 implants; and (d) nor mal, 1 implant, The subcapsular line sign was seen in 26 implants, the teardrop sign was seen in 27 implants, and the keyhole sign was seen in 23 implants, At surgery, 48 implants were found to be ruptured and 38 were intact. The MR findings of ruptured implants showed signs of i ncomplete collapse in 52% (n = 25), linguine sign in 44% (n = 21), and radial folds in 4% (n = 2). The linguine sign perfectly predicted imp lant rupture, but sensitivity was low. Findings of incomplete shell co llapse improved sensitivity and negative predictive values, and the su bcapsular line sign produced a significant incremental increase in pre dictive ability, MRI signs of incomplete shell collapse were more comm on than the linguine sign in ruptured implants and are significant con tributors to the high sensitivity and negative predictive values of MR I for evaluating implant integrity.