MRI Case 17

57 y/o F presents for diagnostic MRI to evaluate implant integrity. What is notable on imaging?

EXTRACAPSULAR SILICONE IMPLANT RUPTURE

  • Intracapsular rupture is a precursor
  • Disruption of the fibrous capsule with silicone infiltrating the surrounding breast parenchyma
  • MRI can be useful in determining extent and location of silicone migration
  • Free silicone will mirror the signal intensity of the silicone found within the implant
  • Mammo: High density material within the breast and lymph nodes (silicone lymphadenopathy)
    • Gel bleed does not indicate rupture
  • US: “Snowstorm sign”

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.