Moschetta M, Telegrafo M, Cornacchia I, Vincenti L, Ranieri V, Cirili A, Rella L, Stabile Ianora A A, Angelelli G
G Chir. 2014 Nov-Dec;35(11-12):274-8.
To evaluate the incidence of Poly Implant Prosthése (PIP) rupture as assessed by magnetic resonance imaging (MRI), the prevalence of the detected signs and the potential correlation with breast carcinoma.
67 patients with silicone breast implants and clinical indications for breast MRI were evaluated for a total of 125 implants: 40 (32%) PIP in 21 patients and 85 non-PIP in 46 patients (68%), the latest considered as control group. A 1.5-T MR imaging device was used in order to assess implant integrity with dedicated sequences and in 6 cases a dynamic study was performed for characterizing breast lesions. Two radiologists with more than 5 years' experience in the field of MRI evaluated in consensus all MR images searching for the presence of clear signs of intra or extra-capsular implant rupture.
20/40 (50%) PIP implants presented signs of intra-capsular rupture: linguine sign in 20 cases (100%), tear-drop sign in 6 (30%). In 12/20 cases (60%), MRI signs of extra-capsular rupture were detected. In the control group, an intra-capsular rupture was diagnosed in 12/85 cases (14%) associated with extra-capsular one in 5/12 cases (42%). Among the six cases with suspected breast lesions, in 2/21 patients with PIP implants (10%) a breast carcinoma was diagnosed (mucinous carcinoma, n=1; invasive ductal carcinoma, n=1). In 4/46 patients (9%) with non-PIP implants, an invasive ductal carcinoma was diagnosed.
The rupture rate of PIP breast implants is significantly higher than non-PIP (50% vs 14%). MRI represents the most accurate imaging tool for evaluating breast prostheses and the linguine sign is the most common MRI sign to be searched. The incidence of breast carcinoma does not significantly differ between the PIP and non-PIP implants and a direct correlation with breast cancer can not been demonstrated.
通过磁共振成像（MRI）评估聚植入假体（PIP）破裂的发生率、所检测到的体征的患病率以及与乳腺癌的潜在相关性。
对67例有硅胶乳房植入物且有乳房MRI临床指征的患者进行了评估，共计125个植入物：21例患者中有40个（32%）PIP植入物，46例患者中有85个非PIP植入物（68%），后者作为对照组。使用1.5-T MR成像设备，通过专用序列评估植入物的完整性，6例进行了动态研究以对乳腺病变进行特征描述。两位在MRI领域有超过5年经验的放射科医生共同评估了所有MR图像，寻找囊内或囊外植入物破裂的明确迹象。
40个PIP植入物中有20个（50%）出现囊内破裂迹象：20例（100%）出现通心粉征，6例（30%）出现泪滴征。在20例中的12例（60%）检测到囊外破裂的MRI迹象。在对照组中，85例中有12例（14%）诊断为囊内破裂，其中5/12例（42%）伴有囊外破裂。在6例疑似乳腺病变的病例中，21例PIP植入物患者中有2例（10%）诊断为乳腺癌（黏液癌，n = 1；浸润性导管癌，n = 1）。46例非PIP植入物患者中有4例（9%）诊断为浸润性导管癌。
PIP乳房植入物的破裂率显著高于非PIP植入物（50%对14%）。MRI是评估乳房假体最准确的成像工具，通心粉征是最常见需要寻找的MRI征象。PIP和非PIP植入物之间乳腺癌的发生率没有显著差异，且无法证明与乳腺癌有直接相关性。
