COMPARATIVE SILICONE BREAST IMPLANT EVALUATION USING MAMMOGRAPHY, SONOGRAPHY, AND MAGNETIC-RESONANCE-IMAGING - EXPERIENCE WITH 59 IMPLANTS
COMPARATIVE SILICONE BREAST IMPLANT EVALUATION USING MAMMOGRAPHY, SONOGRAPHY, AND MAGNETIC-RESONANCE-IMAGING - EXPERIENCE WITH 59 IMPLANTS
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DOI：
10.1097/00006534-199410000-00008
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发表时间：
1994-10-01
影响因子：
3.6
通讯作者：
BASSETT, LW
中科院分区：
文献类型：
--
作者：
AHN, CY;DEBRUHL, ND;BASSETT, LW
随着目前关于硅胶植入物安全性的争议，植入物破裂的检测和评价引起了整形外科医生和患者的关注。我们的研究获得了乳腺X线摄影、超声和磁共振成像（MRI）在检测硅胶植入物破裂中的比较价值分析。29名有症状的患者（总共植入59个硅胶植入物）进入该研究。术中发现21个种植体破裂（36%）。在体格检查期间，阳性“挤压试验”高度提示植入物破裂。获得了51个植入物的乳房X光检查（灵敏度11%，特异性89%）。对57个种植体进行了超声检查（敏感性70%，特异性92%）。对55个种植体进行了MRI检查（敏感性81%，特异性92%）。超声检查，植入物破裂可通过"阶梯征“显示。双腔植入物在超声检查中可能会出现破裂的假阳性结果。在核磁共振成像中，“扁面条征”代表植入物破裂的碎片。植入物破裂检测最可靠的成像方式是MRI，其次是超声。乳房X光检查是最不可靠的。我们的研究支持超声和MRI在评估有症状的乳房植入患者中的临床适应症和诊断价值。
With the current controversy regarding the safety of silicone implants, the detection and evaluation of implant rupture are causing concern for both plastic surgeons and patients. Our study obtained comparative value analysis of mammography, sonography, and magnetic resonance imaging (MRI) in the detection of silicone implant rupture. Twenty-nine symptomatic patients (total of 59 silicone implants) were entered into the study. Intraoperative findings revealed 21 ruptured implants (36 percent). During physical examination, a positive ''squeeze test'' was highly suggestive of implant rupture. Mammograms were obtained of 51 implants (sensitivity 11 percent, specificity 89 percent). Sonography was performed on 57 implants (sensitivity 70 percent, specificity 92 percent). MRI was performed on 55 implants (sensitivity 81 percent, specificity 92 percent). Sonographically, implant rupture is demonstrated by the ''stepladder sign.'' Double-lumen implants may appear as false-positive results for rupture on sonography. On MRI, the ''linguine sign'' represents disrupted fragments of a ruptured implant. The most reliable imaging modality for implant rupture detection is MRI, followed by sonogram. Mammogram is the least reliable. Our study supports the clinical indication and diagnostic value of sonogram and MRI in the evaluation of symptomatic breast implant patients.