A study published in the July 2014 issue of Plastic and Reconstructive Surgery has found that MRI is more accurate than ultrasound in detecting ruptured silicone implants after breast reconstruction.
The authors of the study, from the European Institute of Oncology in Milan, say while ultrasound is still the most appropriate test for routine screening for women with breast implants after mastectomy, the new findings suggest MRI should be used to make a definitive diagnosis of implant rupture, before performing repeat breast surgery.
The study included 102 female patients who had received silicone gel implants for breast reconstruction following mastectomy for breast cancer. The women were undergoing repeat surgery to change the implant for cosmetic reasons. At that time, none of the patients had symptoms of implant rupture or other problems. Before surgery, all patients underwent both MRI and ultrasound scanning. The researchers compared the two imaging methods for their ability to detect ruptured silicone implants.
Twenty-eight percent of the women were found to have implant rupture. Overall, MRI was 94% accurate in detecting ruptured implants, compared to 72 percent accuracy with ultrasound. Magnetic resonance imaging also had a lower “false-negative” rate of five percent, compared to nine percent with ultrasound. Both tests performed well in correctly indicating when implants weren’t ruptured. The “negative predictive value” was 94 percent with MRI and 85 percent with ultrasound.
In conclusion, where available, MRI should be regarded as the preferred imaging test over ultrasound for women with a suspected implant rupture, according to the authors.