Linguine Sign PDF
Linguine Sign PDF
Linguine Sign PDF
Linguine Sign1
APPEARANCE
EXPLANATION
1
From the Department of Radiology, Northwestern Memorial Hospi-
tal, Chicago, Ill. Received March 3, 1998; revision requested April 29;
final revision received April 26, 1999; accepted August 30. Address A trainee (resident or fellow) wishing to submit a manuscript
correspondence to the author, 296 Hawkeye Court, Iowa City, IA for Signs in Imaging should first write to the Editor for approval
52242. of the sign to be prepared, to avoid duplicate preparation of the
RSNA, 2000 same sign.
838
rupture, the fibrous capsule contains the silicone. In extracap- cm seen on multiple consecutive images indicate a ruptured
sular rupture, the silicone breaks free from the ruptured fibrous implant (5). There usually is some undulation of these lines,
capsule and the ruptured implant and leaks into the breast which indicates a free-floating elastomeric shell. Intracapsular
parenchyma. rupture of breast implants can be easily and confidently de-
The linguine sign (Figure) indicates intracapsular rupture of tected with the presence of the linguine sign.
the breast implant. This MR imaging sign is the most sensitive
among all the signs of intracapsular rupture from other imag-
ing modalities, with a sensitivity of 96% and a specificity of References
94% (3). The wavy lines on MR images represent the collapsed 1. Gorczyca D, Sinha S, Ahn C, et al. Silicone breast implants in vivo:
shell floating in the silicone. Although the linguine sign is MR Imaging. Radiology 1992; 185:407 410.
fairly easy to detect, the signs of early intracapsular rupture (4) 2. Gorczyca D. MR imaging of breast implants. Magn Reson Imaging
Clin N Am 1994; 2:659 672.
(tear drop sign, keyhole sign, subcapsular line sign) were more
3. Samuels JB, Rohrich R, Weatherall P, et al. Radiographic diagnosis
common than the linguine sign in a study of 86 breast im- of breast implant rupture: current status and comparison of tech-
plants (5). niques. Plast Reconstr Surg 1995; 96:865 877.
The Silastic elastomeric shell by design is not wrapped tautly 4. Soo MS, Kornguth P, Walsh R, et al. Complex radial folds versus
around the silicone gel. There is room left for the implant to be subtle signs of intracapsular rupture of breast implants: MR find-
ings with surgical correlation. AJR Am J Roentgenol 1996; 166:
molded and be pliable. There is a small amount of natural
14211427.
infolding of the implant shell seen on MR images obtained in 5. Soo MS, Kornguth PJ, Walsh R, et al. Intracapsular implant rupture:
women with intact, normal implants. This may produce cur- MR finding of incomplete shell collapse. J Magn Reson Imaging
vilinear lines similar to the linguine sign. Lines longer than 3 1997; 7:724 730.