MRI Case 1

59 y/o F presents for diagnostic MRI to evaluate implant integrity. What is the most likely diagnosis?

INTRACAPSULAR SILICONE IMPLANT RUPTURE

  • Shell of the implant ruptures but fibrous capsule intact
  • Mammo: typically normal appearance
  • Breast MRI most sensitive for detection of implant integrity; H2O suppressed STIR
    • “Keyhole/teardrop” sign – uncollapsed
    • “Subcapsular line” sign – minimally collapsed
    • “Linguine” sign – fully collapsed
  • Median time to rupture ~10 years, ↑↑↑ with time

Related Radiology Article: Seiler SJ, Sharma PB, Hayes JC, Ganti R, Mootz AR, Eads ED, Teotia SS, Evans WP. Multimodality imaging-based evaluation of single-lumen silicone breast implants for rupture. Radiographics. 2017 Mar;37(2):366-82.