Silicone breast implant rupture: comparison between three-point Dixon and fast spin-echo MR imaging

This study was designed to compare the three-point Dixon technique with our present MR protocol incorporating T2-weighted fast spin echo and fast spin echo with water suppression to detect ruptured silicone breast implants. Eighty-two symptomatic women with silicone breast implants were examined with both the three-point Dixon technique and fast spin-echo MR sequences. Of these patients, 41 had surgery to remove their implants. Four radiologists reviewed the images from only those patients who had surgery and graded each for rupture by using a scale of 1-5. Receiver-operating-characteristic analysis was performed. Of 81 implants removed, 18 were ruptured. Silicone implant ruptures were identified more frequently on the fast spin-echo sequence than on the three-point Dixon sequence, with areas under the ROC curves of .95 and .84, respectively. Although the difference was not statistically significant, the sensitivity for detecting silicone implant rupture was 89% for the fast spin-echo sequence and 61% for the three-point Dixon sequence. The specificity was 97% for both sequences. Silicone implant ruptures were detected more frequently with fast spin-echo MR sequences than with the three-point Dixon technique, although the difference was not significant. The greater spatial resolution used for the fast spin-echo sequence partially accounts for the difference in detection of implant ruptures in this study.