Biomaterial Database

Magnetic resonance evaluation of breast implants and soft-tissue silicone. 1998

M S Middleton

Robert N. Berk Magnetic Resonance Institute, UCSD Department of Radiology, San Diego, California 92103-8749, USA. msm@ucsd.edu

After several years of research in many disciplines, concern for the safety of silicone gel-filled breast implants continues. Although systemic effects of silicone are debated, there is growing consensus that implant rupture and other local breast complications from implants are very real concerns. This paper reviews the history of breast augmentation with an emphasis on the great variety of implants manufactured during the last generation. A classification scheme consisting of 14 breast implant categories is described, and the MR appearance of many is illustrated. The MR signs of implant rupture and pitfalls associated with those signs are reviewed. Indications and contraindications for MR imaging of implants and soft tissue silicone are presented. The author's breast implant and soft-tissue silicone MR imaging experience with follow-up surgical experience over the last 6 years is summarized and discussed. For 1,626 single lumen silicone gel-filled implants imaged, the sensitivity for rupture was 74% and the specificity was 98%. For those implants, 64.9% showed no evidence rupture on MR, 7.9% were indeterminate, and 27.2% were definitely ruptured. Of those that were ruptured, 26.2% had silicone outside as well as within the fibrous capsule. Of the 442 implants that were shown to be ruptured, 54.8% were in a state of uncollapsed rupture, 12.9% minimally collapsed rupture, 4.1% partially collapsed rupture, and 28.3% fully collapsed rupture.

UI	MeSH Term	Description	Entries
D008279	Magnetic Resonance Imaging	Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques.	Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008327	Mammography	Radiographic examination of the breast.	3D-Mammography,Digital Breast Tomosynthesis,Digital Mammography,X-ray Breast Tomosynthesis,3D Mammography,3D-Mammographies,Breast Tomosyntheses, Digital,Breast Tomosyntheses, X-ray,Breast Tomosynthesis, Digital,Breast Tomosynthesis, X-ray,Digital Breast Tomosyntheses,Digital Mammographies,Mammographies,Mammographies, Digital,Mammography, Digital,X ray Breast Tomosynthesis,X-ray Breast Tomosyntheses
D001940	Breast	In humans, one of the paired regions in the anterior portion of the THORAX. The breasts consist of the MAMMARY GLANDS, the SKIN, the MUSCLES, the ADIPOSE TISSUE, and the CONNECTIVE TISSUES.	Breasts
D004868	Equipment Failure	Failure of equipment to perform to standard. The failure may be due to defects or improper use.	Defects, Equipment,Device Failure,Failure, Equipment,Malfunction, Equipment,Medical Device Failure,Misuse, Equipment,Device Failure, Medical,Device Failures, Medical,Failure, Medical Device,Failures, Medical Device,Defect, Equipment,Device Failures,Equipment Defect,Equipment Defects,Equipment Failures,Equipment Malfunction,Equipment Malfunctions,Equipment Misuse,Equipment Misuses,Failure, Device,Failures, Device,Failures, Equipment,Malfunctions, Equipment,Misuses, Equipment
D005260	Female		Females
D005782	Gels	Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquefies; the resulting colloid is called a sol.
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012828	Silicones	A broad family of synthetic organosiloxane polymers containing a repeating silicon-oxygen backbone with organic side groups attached via carbon-silicon bonds. Depending on their structure, they are classified as liquids, gels, and elastomers. (From Merck Index, 12th ed)	Silicone
D016217	Ultrasonography, Mammary	Use of ultrasound for imaging the breast. The most frequent application is the diagnosis of neoplasms of the female breast.	Mammography, Ultrasonic,Breast Ultrasonography,Mammary Ultrasonography,Mammography, Ultrasound,Ultrasonic Mammography,Ultrasonography, Breast,Ultrasound Mammography,Breast Ultrasonographies,Mammary Ultrasonographies,Mammographies, Ultrasonic,Mammographies, Ultrasound,Ultrasonic Mammographies,Ultrasonographies, Breast,Ultrasonographies, Mammary,Ultrasound Mammographies
D018427	Breast Implants	Implants used to reconstruct and/or cosmetically enhance the female breast. They have an outer shell or envelope of silicone elastomer and are filled with either saline or silicone gel. The outer shell may be either smooth or textured.	Breast Prosthesis, Internal,Implants, Breast,Breast Implant,Breast Prostheses, Internal,Implant, Breast,Internal Breast Prostheses,Internal Breast Prosthesis,Prostheses, Internal Breast,Prosthesis, Internal Breast