MR imaging of silicone breast implants: Evaluation of prospective and retrospective interpretations and interobserver agreement

✍ Scribed by Stephen F. Quinn; Nancy M. Neubauer; Robert C. Sheley; Thomas A. Demlow; Jerzy Szumowski

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 762 KB
• Volume: 6
• Category: Article
• ISSN: 1053-1807
• DOI: 10.1002/jmri.1880060137

✦ Synopsis

M R imaging was used to evaluate the integrity of sillcone breast implants in 54 women with 108 implants.

M R images were interpreted by relatively inexperienced readers who tried to reproduce the experiences reported in the literature. The study examines the interobserver agreement using different diagnostic signs and the influence of experience on interpretation errors. Prospective and retrospective interpretations were compared with surgical fhdinge at the time of explantation. Diagnostic indicators, including the lingube sign, the inverted tear drop sign, the C sign, water droplets mixed w i t h silicone. and extracapsular globules of silicone, were evaluated for diagnostic efficacy and interobserver agreement. The prospective sensitivity and speciilcity were 87% and 78%, respectively. With the retrospective interpretations, the sensitiwity and s p e d c i t y increased to 9S% and 92%. respectively. Most of the prospective false-positive Interpretations were due to misinterpreting radial folds as signs of Implant rupture. Six implants interpreted retrospectively as false p i t i v -had gross amounts of silicone around the implants at surgery but there were no obvious rents in the Implant shells. There was f & to excellent interobserver agreement with the individual diagnostic signs except for extracapsular globules of silicone. W of the signs had speciacities of greater than 9045. The sensitivities of the individual signs were less than the overall retrospective eensitivity. With experience, the sensitivity improved from 87% to 93% and the specmcity Improved from 78% to 92%. This study helps substantiate the use of diagnostic signs used by other authors to detect silicone loss from breast implants by MR imaging; however, questions remain as to the clinical role of bfR imaging in evaluating implants for silicone loas. l n d u terms: Breast, MR * Breast, prosiheses * Silicone