扩散加权成像结合动态增强MRI在隆胸术后评估中的应用

Diffusion Weighted Imaging Combined with Dynamic Enhanced MRI in the Evaluation of Breast Augmentation

目的分析隆胸术后假体及并发症的MRI表现,探讨扩散加权成像(DWI)结合动态增强MRI应用于隆胸术后评估的价值。资料与方法收集54例隆胸术后患者,包括水凝胶注射隆胸术17例34个假体,硅胶假体植入隆胸术19例34个假体,自体脂肪移植隆胸术18例36个乳腺,分析假体有无破裂、破裂分型及周围腺体病变的MRI表现。结果水凝胶注射隆胸术组17例34个水凝胶注射假体中,30个假体破裂(聚集型破裂14个,离散型破裂16个),并发乳腺癌1例、脓肿1例;硅胶假体植入隆胸术组19例34个硅胶假体中,未破裂23个(其中包膜挛缩15个),假体破裂11个,其中囊内破裂8个,表现为“包膜下线”征、“索套”征等;囊外破裂3个,表现为假体突破纤维包膜,进入腺体后方或腺体内;并发乳腺癌1例;自体脂肪移植隆胸术18例,表现为乳腺周围脂肪间隙多个环形强化结节。结论不同隆胸术及隆胸材料具有特征性MRI表现,DWI结合动态增强MRI能够准确评估假体有无破裂及破裂类型,并能发现腺体病变。

Purpose To analyze the MRI manifestations of breast implants and complications after breast augmentation,and to explore the value of diffusion weighted imaging(DWI)combined with dynamic enhancement MRI for postoperative evaluation of breast augmentation.Materials and Methods Fifty-four patients underwent MRI examination after breast augmentation,including 17 patients with 34 breast implants after polyacry lamide hydrogel injection,and 19 patients with 34 silicone implants,and 18 patients with 36 autologous fat transplantation.The MRI features of implants and rupture and breast lesion were retrospectively analyzed.Results In 17 patients after polyacry lamide hydrogel injection,30 of 34 breast implants ruptured,including the“aggregate”rupture(14 cases)and the“dissociation”rupture(16 cases).One breast carcinoma and one abscess were detected.In 19 patients with 34 silicone implants,there were 23 non-ruptured implants and 11 ruptured implants.Eight intracapsular rupture implants appeared as“sub-capsular line sign”or“noose sign”.Three extracapsular rupture implants appeared as dissociative implants outside the fibrous capsule.One breast carcinoma was detected.In 18 patients with autologous fat transplantation,nodular with ring enhancement represented fat necrosis distributed retro-mammary space and subcutaneous adipose layer.Conclusion Different breast augmentation and breast augmentation materials have characteristic MRI manifestations.DWI combined with dynamic enhanced MRI can accurately assess whether the prosthesis has rupture and the type of rupture,and can find glandular lesions.