Kuehlmann Britta, Prantl Lukas, Michael Jung Ernst
Center for Plastic, Aesthetic, Hand &Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany.
Department of DiagnosticRadiology and Interdisciplinary Ultrasound Department, University Hospital Regensburg, Regensburg, Germany.
Clin Hemorheol Microcirc. 2016;61(4):645-56. doi: 10.3233/CH-151963.
To investigate whether there are fundamental sonographic and elastographic criteria to precisely assess different surfaces and fillings of idle breast implants and to determine their most distinctive parameters. This was a comparative study of different unused breast implant materials, neighter in animals nor in humans. This knowledge should be transferred in vivo to develop an objective measurement tool.
Nine idle breast implants-silicone and polyurethane (PU)-were examined in an experimental study by using ultrasound B-mode with tissue harmonic imaging (THI), speckle reduction imaging (SRI, level 0-4), cross-beam (CB, low, medium, high), photopic and the colour coded ultrasound-strain elastography with a multifrequency probe (9-15 MHz).Using a standardised protocol the implants' centre as well as the edge were analysed by one experienced examiner. Two independent readers performed analysis and evaluation. For image interpretation a score was created (score 0:inadequate image, score 5:best image quality).
The highest score result for the centre was achieved by using ultrasound with B-mode in addition with CB level medium, SRI level 2, THI and photopic (mean:3.22±SD:1.56), but without any statistic significant difference (t-value = 0.71). With elastography the implants' edge in general was represented without disruptive artefacts (3.89±0.60) with statistic significant difference (t-value = 5.29). Implants filled with inner cohesive silicone gel II° showed best imaging conditions for their centre via ultrasound (5±0) as well as for their edge via elastography (4.50±0.71).
Ultrasound-strain elastography and high resolution ultrasound represent a valuable measurement tool to evaluate different properties of idle breast implants. These modified ultrasound examinations could be an additional help for clinical investigations and be correlated with Baker's Classification.
研究是否存在能够精确评估闲置乳房植入物不同表面和填充物的基本超声和弹性成像标准，并确定其最具特征性的参数。这是一项针对不同未使用乳房植入材料的比较研究，未在动物或人体中进行。该知识应转化到体内以开发一种客观的测量工具。
在一项实验研究中，使用带有组织谐波成像（THI）的超声B模式、散斑减少成像（SRI，0 - 4级）、交叉波束（CB，低、中、高）、明视觉以及使用多频探头（9 - 15MHz）的彩色编码超声应变弹性成像，对九个闲置乳房植入物（硅胶和聚氨酯（PU））进行检查。使用标准化方案，由一名经验丰富的检查者对植入物的中心以及边缘进行分析。两名独立的读者进行分析和评估。为图像解释创建了一个评分（评分0：图像不充分，评分5：最佳图像质量）。
通过使用超声B模式并结合CB中级、SRI 2级、THI和明视觉，植入物中心获得了最高评分结果（平均值：3.22±标准差：1.56），但无任何统计学显著差异（t值 = 0.71）。使用弹性成像时，植入物边缘总体上没有干扰伪像（3.89±0.60），具有统计学显著差异（t值 = 5.29）。填充内部粘性硅胶凝胶II°的植入物通过超声对其中心（5±0）以及通过弹性成像对其边缘（4.50±0.71）显示出最佳成像条件。
超声应变弹性成像和高分辨率超声是评估闲置乳房植入物不同特性的有价值测量工具。这些改进的超声检查可为临床研究提供额外帮助，并与贝克分类法相关联。
