الفهرس 
TYPES OF BREAST IMPLANTSOnly 14 pages are availabe for public view
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Abstract
There are advantages and disadvantages to all imaging modalities used in the evaluation of implant integrity. Mammography is rapid and inexpensive, but it is of limited usefulness in detecting implant rupture in women with silicone implants. It is very inaccurate for intracapsular rupture and will reliably detect extruded silicone only in an extracapsular rupture. Implants placed in a subpectoral position do not interfere with mammography to the same extent as subglandular implants. Data on whether cancer detection is impaired by implants do not allow definite conclusions, although it is clear that implants do interfere with screening mammography by obscuring a variable part of breast tissue, distorting breast architecture, and especially in the presence of firm contractures, making a proper examination with proper compression of the breast more difficult and occasionally impossible.
Ultrasound has the potential to detect both intra- and extracapsular ruptures, is inexpensive, and uses no ionizing radiation. However, it is a highly operator-dependent study that is less accurate in the presence of capsular contracture and is unable to visualize the posterior surface of the implant. The sensitivity of the examination is greater than mammography.
MRI has the highest sensitivity and specificity for evaluation of implant integrity and is the most accurate imaging modality for the detection of intra- and extracapsular rupture. It has none of the limitations of mammography or ultrasound, but it is expensive and time-consuming. MRI requires modern dedicated breast-imaging coils, and necessitates a thorough knowledge of implants and of potential diagnostic pitfalls. Detailed information regarding the type of implant and surgical technique, the time interval since surgery and any radiotherapy should be available before the examination is interpreted. The excellent soft tissue resolution provided by MRI and its ability to demonstrate implant integrity are valuable in assessing the augmented and reconstructed breast. Noncontrast MRI, using multiple planes and employing sequences designed to evaluate the internal structure of the implant and to assess for extracapsular silicone, is the most sensitive imaging modality available to assess for silicone implant rupture. Furthermore, contrast-enhanced MRI may assist in depicting cancer in augmented breasts and may allow biopsy to be avoided: the use of intravenous contrast and ability to image posterior tissues are particularly valuable in women in whom mammography is compromised by the presence of implants.
Although expensive and possibly unavailable, MRI is considered the modality of choice for imaging women with breast implants. It has the potential to address questions raised or unanswered with traditional diagnostic imaging methods as it has the highest sensitivity and specificity for detection of implant rupture, together with its ability to assess the breast tissue surrounding the implant.