磁共振成像 SPACE 序列在隆乳术后包膜挛缩中硅凝胶假体的三维成像。

3D images of the silicone implants in capsular contracture after breast augmentation using magnetic resonance imaging with SPACE sequence.

机构信息

Department of Plastic Surgery, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, 1095 Jiefang Road, Wuhan, Hubei, China.

Department of Radiology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, 1095 Jiefang Road, Wuhan, Hubei, China.

出版信息

J Plast Reconstr Aesthet Surg. 2021 Sep;74(9):2210-2216. doi: 10.1016/j.bjps.2020.12.081. Epub 2021 Jan 9.

DOI:10.1016/j.bjps.2020.12.081

PMID:33526362

Abstract

BACKGROUND

Capsular contracture is a common complication after breast augmentation. However, no objective methods are available to assess capsular contracture at present. The goal of the present study was to evaluate the correlation between capsular contracture and 3D images of the silicone implants by using magnetic resonance imaging (MRI) with sampling perfection with application optimized contrast using different flip angle evolutions (SPACE) sequence.

METHODS

Twenty-one patients (42 breasts) underwent breast augmentation, had postoperative MRI examinations with SPACE sequence, and the evaluation of the Baker grade by two trained plastic surgeons. Capsular thickness was measured on the T2-weighted images. The software ITK-SNAP was used to reconstruct 3D images of the implants. The fold characteristics such as number, depth, direction, and distribution were compared with the Baker grade.

RESULTS

Of the 42 breasts, 14, 8, 12, and 8 breasts were classified as Baker grade I, II, III, and IV, respectively. The MRI images of breasts with Baker grade III or IV revealed a thicker capsule (mean of 2.29 mm) as compared to the capsule with the lower Baker grades (mean of 1.58 mm). The 3D images of implants showed no difference in the number of folds between the groups with different Baker grades. The fold direction and fold distribution differed between grade I to II and grade III to IV.

CONCLUSION

The 3D image of an implant with pathological folds is a potential and feasible diagnostic indication of capsular contracture.

LEVEL OF EVIDENCE

IV.

摘要

背景

包膜挛缩是乳房隆乳术后的常见并发症。然而，目前尚无评估包膜挛缩的客观方法。本研究旨在通过磁共振成像（MRI）采用采样完美应用优化对比使用不同翻转角演化（SPACE）序列评估包膜挛缩与硅酮植入物的 3D 图像之间的相关性。

方法

21 例（42 侧乳房）患者接受乳房隆乳术，术后采用 SPACE 序列行 MRI 检查，并由 2 名经过培训的整形外科医生进行 Baker 分级评估。在 T2 加权图像上测量包膜厚度。使用 ITK-SNAP 软件重建植入物的 3D 图像。比较折叠特征，如数量、深度、方向和分布与 Baker 分级的关系。

结果

42 侧乳房中，Baker 分级分别为 I、II、III 和 IV 级的乳房各有 14、8、12 和 8 个。Baker 分级为 III 或 IV 级的乳房的 MRI 图像显示包膜较厚（平均 2.29mm），而包膜分级较低的乳房（平均 1.58mm）。不同 Baker 分级组之间的折叠数量在 3D 图像的植入物上无差异。折叠方向和折叠分布在 I 级至 II 级和 III 级至 IV 级之间存在差异。