[1]韩中强,占 鸣,谢春梅,等.聚丙烯酰胺水凝胶注射隆乳术后并发症的MRI表现及不同序列的诊断价值[J].医学信息,2021,34(16):184-186.[doi:10.3969/j.issn.1006-1959.2021.16.053]
 HAN Zhong-qiang,ZHAN Ming,XIE Chun-mei,et al.MRI Manifestations of Complications After Breast Augmentation by Polyacrylamide Hydrogel Injection and the Diagnostic Value of Different Sequences[J].Medical Information,2021,34(16):184-186.[doi:10.3969/j.issn.1006-1959.2021.16.053]
点击复制

聚丙烯酰胺水凝胶注射隆乳术后并发症的MRI表现及不同序列的诊断价值()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年16期
页码:
184-186
栏目:
诊疗技术
出版日期:
2021-08-15

文章信息/Info

Title:
MRI Manifestations of Complications After Breast Augmentation by Polyacrylamide Hydrogel Injection and the Diagnostic Value of Different Sequences
文章编号:
1006-1959(2021)16-0184-03
作者:
韩中强占 鸣谢春梅
(浙江萧山医院放射科,浙江 杭州 311202)
Author(s):
HAN Zhong-qiangZHAN MingXIE Chun-meiet al.
(Department of Radiology,Zhejiang Xiaoshan Hospital,Hangzhou 311202,Zhejiang,China)
关键词:
聚丙烯酰胺水凝胶隆乳术假体囊壁破裂乳房硬结MRI
Keywords:
Polyacrylamide hydrogelAugmentation mammoplastyRupture of prosthetic capsule wall Breast indurationMRI
分类号:
R655.8;R445.2
DOI:
10.3969/j.issn.1006-1959.2021.16.053
文献标志码:
A
摘要:
目的 探讨聚丙烯酰胺水凝胶注射隆乳术后并发症的MRI表现,评估MRI不同序列对注射隆乳术后并发症的诊断价值。方法 收集 2016年6月~2019年12月聚丙烯酰胺水凝胶注射隆乳术后到本院就诊的患者19例,全部为女性,年龄37~58岁,平均41岁。全部患者于术前行 MRI 检查,并于检查后1周内行手术切开水凝胶取出术,清理变性坏死组织并送病理检查。结果 15例患者共29只乳房出现并发症。14例(27个)出现假体囊壁破裂,表现为外形欠规则,囊壁不连续,内部信号不均,可见单个或多个线样、片状T1WI等、低信号,T2WI低信号阴影;13例(26个)见乳房硬结,表现为皮下、腺体、包膜邻近、肌间隙内呈圆形或类圆形的结节影;3例(5个)有无菌性炎症,表现为胸大肌结构破坏,T2WI抑脂序列、DWI序列信号增高,胸大肌前间隙、乳腺组织内有条索状T2WI高信号影,假体与周围组织间隙模糊不清,乳腺结构紊乱;1例(1个)可见金属异物残留。各序列图像中,对并发症诊断敏感性最高的是T2WI序列,为93.7%;特异性最高的是DCE-MRI序列,为88.89%。结论 MRI可清楚显示聚丙烯酰胺水凝胶的分布情况及其与周围组织的关系,帮助确定手术指征和手术方式等方面均有明显优势,其中T2WI序列及DCE-MRI序列的最具诊断价值,可作为注射水凝胶患者的诊断、评价手术效果以及术后随访的首选检查方法。
Abstract:
Objective To investigate the MRI manifestations of complications after polyacrylamide hydrogel injection for breast augmentation, and to evaluate the diagnostic value of different sequences of MRI in the diagnosis of complications after breast augmentation.Methods A total of 19 patients who came to our hospital after breast augmentation by polyacrylamide hydrogel injection from June 2016 to December 2019 were collected. All of them were female, aged 37-58 years old, with an average of 41 years old.All patients underwent MRI examination before the operation, and within 1 week after the examination, underwent surgical incision and removal of the hydrogel to clean up the degenerated and necrotic tissue and send for pathological examination.Results There were complications in 29 breasts of 15 patients.14 cases (27) had rupture of the prosthetic capsule wall, manifested as irregular shape, discontinuous capsule wall, uneven internal signal, single or multiple line patterns, patchy T1WI, etc., low signal, T2WI low signal shadow;13 cases (26) showed breast induration, which showed round or round-like nodules under the skin, glands, adjacent capsules, and intermuscular spaces;3 cases (5) had aseptic inflammation, manifested as structural destruction of the pectoralis major muscle, increased T2WI lipid suppression sequence, DWI sequence signal, and cord-like T2WI high signal shadow in the anterior pectoralis major space and breast tissue.The gap between the prosthesis and the surrounding tissues was blurred, and the breast structure was disordered;In 1 case (1), metal foreign matter remained. Among the images of each sequence, the T2WI sequence was the most sensitive to the diagnosis of complications, which was 93.7%;The DCE-MRI sequence with the highest specificity was 88.89%.Conclusion MRI can clearly show the distribution of polyacrylamide hydrogel and its relationship with surrounding tissues, and has obvious advantages in helping to determine surgical indications and surgical methods. Among them, T2WI sequence and DCE-MRI sequence have the most diagnostic value It can be used as the first-choice examination method for the diagnosis of patients with hydrogel injection, evaluation of surgical effects, and postoperative follow-up.

参考文献/References:

[1]Umar D,Khan U.Augmentation mastopexy and augmentation mammoplasty:an analysis of 1,406 consecutive cases[J].Plastic and Aesthetic Research,2016,3(1):26-30. [2]Winter J,Shiga S,Islur A.Complications of Polyacrylamide Hydrogel Augmentation Mammoplasty:A Case Report and Review of the Literature[J].Plastic Surgery Case Studies,2016,2(3):47-50. [3]荣凡令,王思奇,蒋燕妮.3.0TMR对隆乳后乳腺的诊断价值[J].南京医科大学学报(自然科学版),2015,35(4):572-575. [4]Seiler SJ,Sharma PB,Hayes JC,et al.Multimodality Imaging-based Evaluation of Single-Lumen Silicone Breast Implants for Rupture[J].Radio Graphics,2017,37(2):366-382. [5]王蓼,胡竺,水淼,等.MRI对聚丙烯酰胺水凝胶注射隆乳术后并发症的诊断[J].实用放射学杂志,2012,28(8):1211-1213. [6]Chen B,Song H.Management of Breast Deformity After Removal of Injectable Polyacrylamide Hydrogel:Retrospective Study of 200 Cases for 7 Years[J].Aesthetic Plastic Surgery,2016,40(4):482-491. [7]任聪聪,许茂盛,刘玉凤.动态增强MR结合ADC诊断年轻女性乳腺癌的价值[J].浙江临床医学,2016(5):946-947. [8]Wong T,Lo LW,Fung P,et al.Magnetic resonance imaging of breast augmentation:a pictorial review[J].Insights Into Imaging,2016,7(3):399-410. [9]丁宁,孔令燕,金征宇,等.乳房聚丙烯酰胺水凝胶与硅胶假体向邻近组织浸润的磁共振对比[J].影像诊断与介入放射学,2018,27(4):29-33. [10]鲁开化,曹景敏,周智,等.医用聚丙烯酰胺水凝胶豚鼠体内注射的实验观察[J].实用美容整形外科杂志,2000,11(1):1-3. [11]金光暐,蔡幼铨,安宁豫,等.VIBRANT多时相增强MRI鉴别乳腺良恶性病变的应用研究[J].中国医学影像技术,2007,23(5):678-682. [12]邹同荣,杜永贵,陈国双,等.结合MRI对聚丙烯酰胺水凝胶注射隆乳材料清除的临床研究[J].中国医疗美容,2016,6(1):30-32.

更新日期/Last Update: 1900-01-01