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Addition of real-time elastography to ultrasound a helpful addition for detection of implant rupture

Sonoelastography analyzes tissue elasticity and can be a powerful tool when used along with high-resolution ultrasound for the detection of ruptured breast implants, according to researchers.

In the first phase of a two-phase study, a pilot study assessed the use of elastography in two patients with breast implants who were scheduled for follow-up as a result of the Poly Implant Prosthesis scandal. Unilateral breast implant failure was suspected in both patients as a result of the ultrasound. Elastography confirmed the presence of two normal and two ruptured implants.

In the two implants with normal findings, elastography results showed a typical blue-green-red pattern. In the abnormal left implant of patient one, elastography revealed a mixed pattern of green and blue regions without typical layering. In patient two, elastogram results were similar to those of patient one, with an identical pattern of abnormality observed.

In both patients, MRI and surgical findings confirmed the implant ruptures.

Phase 2, a prospective trial, included 14 patients who received breast implants for cosmetic or reconstruction purposes.

In 11 out of the total 16 patients (Phase 1 and 2), symptoms presented as pain or a palpable mass. Clinical examination showed no signs of implant failure in any case, according to the researchers.

Quality, useable elastograms were produced within 5 minutes, and implant rupture was diagnosed in five of 28 implants and confirmed by surgery.

Elastography in the region of ruptures revealed an irregular red-green-yellow pattern toward the lower part of the prosthesis, and almost blue in the upper part of the breast. All of the patients with positive sonographic findings of intracapsular implant rupture also underwent MRI, and surgery was used in all cases to confirm the rupture.

The researchers concluded elastography combined with high-resolution ultrasound was easy to perform, did not require a lot of training and could be verified by real-time elastography. An expensive MRI is unnecessary with a definite ultrasound diagnosis of implant failure, according to researchers.