MRI三维重建在聚丙烯酰胺水凝胶注射隆乳术后诊断中的应用

目的 探讨聚丙烯酰胺水凝胶注射隆乳术后分布的有效诊断方法.方法 对聚丙烯酰胺水凝胶注射隆乳术后的患者进行双侧乳房MRI薄层扫描(层厚1 mm,t2_ps3d_cor序列),在计算机上运用Amira电脑软件模块对扫描信息分别进行体积重建和表面重建,观察水凝胶的分布范围和部位,并计算其体积.结果 自2007年3月以来,于临床应用23例(46只乳房),其中5例(10只)水凝胶位于乳房后间隙,包膜完整,分布均匀,无移位;6例(12只)注射的水凝胶包膜不完整,形态不规则,边缘不整,呈多处散在的团块分布;11例(22只)水凝胶浸及胸大肌内、胸大肌后方、乳腺组织内和皮下,1例(2只)外院双侧取除水凝胶术后复查发现仍有少量残留,散在分布于乳腺及变性肌肉组织中.初次就诊的22例(44只)注射水凝胶的总体积为220.309～372.371 ml,平均306.328ml.结论 MRI三维重建能清晰显示注射物的体积和分布范围,可以有效地指导水凝胶的手术取除.

3-dimensional reconstruction of MRI in patients with polyacrylamide hydrogel injection for augmentation mammoplasty

Objective To investigate the effective diagnostic method for the patients with polyacrylamide hydrogen injection for augmentation mammaplasty.Methods MRI scanning (layer thickness 1mm,t2_ ps3d_cor alignment) was performed on 23 patients with polyacrylamide hydrogen injection for augmentation mammaplasty.The data were imported into computer and processed.3D reconstruction and analysis modules were nm subsequently to do the volume recunstmction and surface reconstruction to obtain stereoscopic images of the gel and adjacent structures in virtual reality,and to calculate the volume of the hydrngel.Results Among the 23 patients (46 breasts),the injected hydrngel with integrity capsule existed in retromammary space with no malpostition in 5 cases (10 breasts).The capsule was not integrally formed and hydrogel was separately distributed with irregular edge in 6 patients (12 breasts).The pectoris major space,subcutaneous and gland invasion was found in 11 patients (22 breasts).Small amount of hydrogel sparsely distributed in mammary gland and degenerative muscular tissue in 1 patient (2 breasts) who had received extracting surgery before.The volume of hydrngel ranged from 220.309 ml to 372.371 ml (mean:306.328 ml) in 22 untreated patients (44 breasts).Conclusions The volume and distribution of hydrogel can be known clearly by 3D MRI reconstruction technique.This feasible technique is helpful in removing the hydrogel completely.