乳房假体植入后破裂及泄漏的MRI表现

目的：探讨磁共振诊断乳房假体破裂和（或）泄漏的临床价值。方法：对17例隆乳术后患者行MR扫描，对1个体外正常硅胶液硅胶囊袋假体行相同序列MR扫描作为正常参照。对囊袋假体及注射聚丙烯酰胺假体的MR表现进行分类分析。结果：正常硅胶囊袋单腔假体7例12个，其中4例8个囊内为硅胶液；3例4个囊内为生理盐水。生理盐水硅胶囊袋单腔假体破裂2例2个，其中1 个属囊内破裂，MRI示残留塌陷的硅胶囊袋呈长条状长T1、短T2信号；另1个属囊外破裂，MRI示假体内有多条丝状短T2低信号，即“条丝征”，同侧乳房外见假体内容物颗粒。注射聚丙烯酰胺假体10例20个，其中1例2个完整；8例16个完全破裂，表现为多发条块状、结节状长T1、长T2信号，8例中有7例见双侧乳房腺体内及乳房外有注射物颗粒；1例2个内部撕裂，MRI表现为假体内有多发“条丝征”。结论：MR检查可明确乳房假体的类型、位置；明确假体破裂类型及漏出物的分布范围；因此能为临床手术提供准确定位，为随访复查提供客观资料。

MR images of rupture and leakage of breast implants

Objective To investigate the diagnostic value of magnetic resonance imaging in detecting rupture and leakage of breast implants. Methods Seventeen cases with breast implants were imaged by MR scanner.1 normal silicone breast implant outside the body was scanned by MR as an consultative standard. MR images of silicone implants and polypropylene acyl amine implants were classified and analyzed. Results In 7 cases, 12 single lumen silicone implants were intact, among them 8 were silicone gel filled implants, 4 were physiological saline filled implants. 2 physiological saline filled implants ruptured, among them 1 belonged to intracapsular silicone implant rupture with subsided silicone gel capsule which presented as long T 1 signal and short T 2 signal on MR images; The othor belonged to extracapsular silicone implant rupture with physiological saline granule outside breast on MR images. 20 breast implants in 10 cases were injected by polypropylene acyl amine, among them 2 breast implants were intact, 16 breast implants ruptured completely with pieces and nodes of long T 1 signal and long T 2 signal on MR images,14 of 16 also presented polypropylene acyl amine granule outside breast; 2 breast implants splited inside with linguine sign. Conclusion The magnetic resonance imaging can make clear the type and the seat of breast implants, the type of rupture of breast implants, and the distribution of leakage material. Therefore magnetic resonance imaging can be an effective guidance for clinical operation and can be an consultative standard for follow up.