磁共振对聚丙烯酰胺水凝胶隆乳术后并发症的诊断价值  

MRI in Diagnosis of Complications Due to Breast Augmentation with Polyacrylamide Hydrogel

作　　者：戴文静 姚立辉[2] 张伟[3] DAI Wen-jing;YAO Li-hui;ZHANG Wei(Department of Radiology,Jilin City People's Hospital;Ultrasonic Diagnosis and Treatment Center ,The Centraf Hospital of Jilin;Department of Radiology,Shengjing Hospital of China Medical University)

机构地区：[1]吉林市人民医院放射科 [2]吉林市中心医院超声科 [3]中国医科大学附属盛京医院放射科

出　　处：《中国医学计算机成像杂志》2019年第4期400-404,共5页Chinese Computed Medical Imaging

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对注射隆乳术后并发症的诊断价值。方法:收集2006年1月-2017年12月接受聚丙烯酰胺水凝胶注射隆乳术后出现不适而到本院就诊的患者50例,全部为女性,年龄25-64岁,平均年龄48岁。全部患者于术前行MRI检查,并于检査后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:假体囊壁破裂45例89只乳房,MRI表现为假体形态不规整,边缘凸凹不平,内信号多数不均匀,并多发低信号分隔影,致高信号假体被分隔成单发或多发条块状、结节状;43例74只乳房假体出现不同程度移位,呈不规则游离状,表现为类圆形、卵圆形或不规则形多团块游离分布于乳房各处,大小不一;10例12只乳房发生变形,表现为一侧乳房明显变大,或由于移位导致局部突起等;10例患者15只乳腺存在感染;11例患者12只乳腺腺体内出现肿块或结节,其中恶性肿瘤5例5只,乳腺腺病1例1只,乳腺纤维腺瘤4例4只,乳腺囊肿1例2只;3例患者6只乳房已行手术将水凝胶取出,复査MRI发现有残留,表现为斑片状、结节状T2WI高信号影。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,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査方法。Purpose:To explore the MRI features of complications after polyacrylamide hydrogel injection of breast augmentation,and to evaluate the diagnostic value of MRI for postoperative complications after injection of breast augmentation.Methods:Fifty cases of 2006.1-2017.12 were collected from the hospital after the polyacrylamide hydrogel injection of breast augmentation.All of the women aged from 25 to 64 years old with mean age of 48 years old.All patients were examined by MRI before the operation.The surgical removal of hydrogel was performed within 1 week after the examination.The degenerative and necrotic tissues were cleaned and sent to the pathological examination.Results:Ruptures of the wall of the prosthesis occurred in 45 cases of 89 breasts.MRI findings showed irregular morphologic prosthesis with the edge of convex and concave.Most of them were inhomogeneous and many were separated with by hypointense septum.Hyperintense prosthesis was divided into single strip or multiple nodules.In 43 cases,74 breast prostheses had different degrees of displacement.There were round,oval or irregular clusters of multiple lumps scattered through the breast in different sizes.In 10 cases,12 breasts were deformed,which showed that one side of the breast was obviously enlarged,or the local protuberance occured due to the displacement.Ten cases with 15 breast infections were observed,11 cases with 12 breasts had masses or nodules,of them,5 malignant tumors were observed in 5 cases.And one case of breast adenosis,4 cases of breast fibroadenoma,and 1 case of 2 breast cysts were also oberved.In 3 patients with 6 hyclrogel-removed breasts,MRI showed patch-like or nodular residue with long T2 signal.Conclusion:MRI can clearly show the distribution of polyacrylamide hydrogel and its relationship with the surrounding tissue;it has obvious advantages in helping to determine the surgical operation.It can be used as the first choice for the diagnosis,evaluation and follow-up of patients with the hydrogel injection operation.

关 键 词：聚丙烯酰胺水凝胶 MRI 隆乳术 

分 类 号：R445.2[医药卫生—影像医学与核医学]