| Teaching File Case - Patient: 12316|
Peer Reviewed and Certified - Approved by: Albert V Porambo - 2008-08-13 22:34:22-04
|Demographics: 25 y.o. woman|
|History & Chief complaint:|
|25 year old woman with trauma to right breast.|
|Physical exam and Laboratory:|
| Right breast with asymmetry. |
|Summary of Findings:|
|MR images of the right breast demonstrate a fine serpentine low signal intensity linear band within the silicon implant.|
| Intracapsular rupture of silicone breast implant |
|Confirmed by: imaging|
|Treatment and Followup:|
|The patient was referred to her surgeon for replacement of the implant.|
|Patient Specific Discussion: (Also Read the Disease Discussion)|
|This case demonstrates an intracapsular rupture of a silicon breast implant with a classic linguine sign.|
|Intracapsular rupture defined as a disruption of the implant envelope, with the implant contents contained by the surrounding fibrous capsule.
The MR appearance of intracapsular rupture include serpentine low signal intensity linear bands within the silicone implant as indicative of a disrupted envelope collapsing and falling into the gel. In cross section it was thought to look like a piece of pasta weaving back and forth on a plate and was termed the linguine sign. Others call it the fallen envelope sign.
In an intracapsular rupture the implant gel is held in place by the fibrous capsule, which may or may not be identified on the MR images.
The linguine sign is the best evidence of a ruptured implant, several series show a high correlation of the linguine sign with rupture, reporting 76-94% sensitivities and 97-100% specificities.
Spontaneous ruptures can occur in 10-20 percent, and traumatic ruptures are usually clinically evident.
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