Complex radial folds versus subtle signs of intracapsular rupture of breast implants: MR findings with surgical correlation

Detection of intracapsular rupture of silicone breast prostheses using MR imaging is often performed by identifying the ''linguine sign'' [1]. The linguine sign is easily differentiated from simple radial folds that are seen in intact implants, However, more subtle signs of intracapsular rupture, including undulating subcapsular lines and the ''teardrop sign:'' are less often recognized [2-5] and may prove difficult for the less experienced radiologist to differentiate from complex radial folds of intact implants. In this essay, we illustrate the MR imaging findings of complex radial folds in intact implants and compare them with findings of incomplete shell collapse in ruptured implants in a surgically confirmed series of explanted silicone breast prostheses.