On MRI, which sign is associated with intracapsular rupture?

• A. Linguini sign - MRI
• B. Intra-capsular implant rupture
• C. Extra-capsular implant rupture
• D. Intracapsular implant rupture

Answer: (A)

The main concept is recognizing how intracapsular rupture appears on MRI. When the implant shell ruptures but the fibrous capsule remains intact, the shell collapses inside the capsule and the collapsed shell shows up as multiple thin, wavy lines within the silicone gel. This pattern resembles strands of linguine pasta, hence the linguine sign. It’s highly specific for intracapsular rupture because the silicone stays contained inside the capsule, even though the shell is torn.

If the rupture were extracapsular, silicone would extend outside the capsule into surrounding breast tissue, and you would not see the folded shell strands that define the linguine sign. The other phrasing simply describes rupture location rather than the characteristic imaging appearance, so they don’t indicate this specific MRI sign.