Prantl L, Englbrecht M A, Schoeneich M, Kuehlmann B, Jung E M, Kubale R
Center for Plastic, Aesthetic, Hand & Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany.
Department of Radiology, University Hospital Regensburg, Regensburg, Germany.
Clin Hemorheol Microcirc. 2014;58(4):521-8. doi: 10.3233/CH-141812.
To estimate the presence and severity of capsular contracture in patients after breast implants an objective measurement tool is necessary.
Eleven patients (range of age 37 to 53 years) who underwent cosmetic breast augmentation (seven patients with bilateral implants) or breast reconstruction by mammary asymmetry (four patients unilateral) with smooth silicone gel implants were included in this prospective study. In total seventeen implants were examined clinically and with the colour coded Ultrasound Elastography using a multifrequency probe (5-10 MHz Siemens Antares Premium VFX13-5). The grade of capsular contracture was assessed by two examiners with the palpation method and classified according to the Baker score. The Ultrasound Elastography was performed by two radiologists specialized in breast imaging and was correlated with the Baker score, colour coded ultrasound elastography and a high resolution ultrasound B-scan score (0-5).
The clinical examination proved following distribution of the Baker degree: 6 breast implants with Baker grade I and Baker grade II, 3 breast implants with Baker grade III and two breast implants with Baker grade IV. There was a high correlation between the Baker score and the objective scoring measured by Ultrasound Elastography (kappa 0.83-0.89).
The new technology of Ultrasound Elastography represents a useful tool to evaluate the compressibility of the peri-implant capsule, the implant and the surrounding tissue.
为了评估乳房植入术后患者包膜挛缩的存在情况及严重程度,需要一种客观的测量工具。
本前瞻性研究纳入了11例患者(年龄范围37至53岁),这些患者接受了美容性隆乳术(7例双侧植入)或因乳房不对称进行的乳房重建术(4例单侧),均使用了光滑硅胶凝胶假体。总共对17个假体进行了临床检查,并使用多频率探头(5 - 10 MHz西门子Antares Premium VFX13 - 5)进行了彩色编码超声弹性成像检查。两名检查者通过触诊法评估包膜挛缩的等级,并根据贝克评分进行分类。超声弹性成像由两名专门从事乳腺成像的放射科医生进行,且与贝克评分、彩色编码超声弹性成像以及高分辨率超声B扫描评分(0 - 5)相关。
临床检查显示贝克分级的分布如下:6个乳房假体为贝克I级和贝克II级,3个乳房假体为贝克III级,2个乳房假体为贝克IV级。贝克评分与超声弹性成像测量的客观评分之间存在高度相关性(kappa值为0.83 - 0.89)。
超声弹性成像新技术是评估植入物周围包膜、植入物及周围组织可压缩性的有用工具。