Ultrasound versus MRI for evaluation of silicone leakage from silicone breast implants.

Heliyon

Section General Internal Medicine, Department of Internal Medicine, Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, location VUmc, Amsterdam, the Netherlands.

Published: June 2024

AI Article Synopsis

  • Silicone breast implants often face issues like ruptures and gel bleed, and while MRI is seen as the best imaging method, recent studies indicate that ultrasound might also be effective.
  • This study involved 104 women who underwent both ultrasound and MRI on the same day, with radiologists evaluating the results for accuracy in detecting implant ruptures and silicone deposits in lymph nodes.
  • Findings revealed that ultrasound was highly accurate (96%) for detecting ruptures and was better than MRI for finding silicone in lymph nodes, leading to a recommendation to start examinations with ultrasound before using MRI if needed.

Article Abstract

Background: Implant ruptures and gel bleed are not uncommon among women with silicone breast implants. While magnetic resonance imaging (MRI) is traditionally considered the gold standard diagnostic modality, recent studies suggest ultrasound might be an acceptable alternative. This study compares the efficacy of ultrasound and MRI in assessing implant integrity.

Methods: Women with silicone breast implants underwent a breast and axillary ultrasound and MRI on the same day. All tests were assessed by experienced radiologists. The accuracy, sensitivity, and specificity of ultrasound and MRI for implant rupture detection and silicone depositions in axillary lymph nodes were evaluated.

Findings: A total of 104 women participated in the study. The accuracy, sensitivity, and specificity of ultrasound for detecting implant ruptures compared to MRI were 96 %, 95 %, and 96 %, respectively. MRI demonstrated significantly lower sensitivity (44 %) for detecting silicone depositions in axillary lymph nodes compared to ultrasound. A significant association was observed between the presence of enlarged axillary lymph nodes and/or axillary pain and the detection of silicone depositions in axillary lymph nodes on ultrasound (χ (1,  = 104) = 5·1,  = 0·024). Six women exhibited silicone depositions in axillary lymph nodes despite having intact first-pair implants, indicative of gel bleed.

Interpretation: Ultrasound is nearly as effective as MRI for detecting breast implant ruptures and is superior for detecting silicone depositions in axillary lymph nodes. We therefore recommend initiating radiological examination in women with breast implants with a breast and axillary ultrasound, proceeding to MRI only if the ultrasound is inconclusive. The prevalence of gel bleed is understudied and its potential adverse health effects might be underestimated. Further research is needed to explore its potential association with development of systemic symptoms.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11253520PMC
http://dx.doi.org/10.1016/j.heliyon.2024.e33325DOI Listing

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