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  

MRI Manifestations of Complications After Breast Augmentation by Polyacrylamide Hydrogel Injection and the Diagnostic Value of Different Sequences

作　　者：韩中强 占鸣[1] 谢春梅 高明 HAN Zhong-qiang;ZHAN Ming;XIE Chun-mei;GAO Ming(Department of Radiology,Zhejiang Xiaoshan Hospital,Hangzhou 311202,Zhejiang,China)

机构地区：[1]浙江萧山医院放射科,浙江杭州311202

出　　处：《医学信息》2021年第16期184-186,共3页Journal of Medical Information

基　　金：杭州市医药卫生科技项目(编号:B20200234)。

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。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 diagnost

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 

分 类 号：R655.8[医药卫生—外科学] R445.2[医药卫生—临床医学]