Center for Plastic, Aesthetic, Hand & Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany.
Institute of Biotechnology, Molecular Cell Biology, Brandenburg University of Technology, Senftenberg, Germany.
Clin Hemorheol Microcirc. 2022;80(4):487-495. doi: 10.3233/CH-219204.
This study aims to evaluate optimized breast implant surface-structure analysis by comparing high-end ultrasound technology with a new high frequency technique. This comparative study used new breast implants with different surfaces in an in vitro setting.
Nine idle silicon or polyurethane (PU) breast implants were examined by two investigators in an experimental in vitro study using two high-end ultrasound devices with multi-frequency transducers (6-15 MHz, 9-16 MHz, 12.5-33 MHz).The ultrasound B-Mode was optimized using tissue harmonic imaging (THI), speckle reduction imaging (SRI, level 0-5), cross beam (high, medium, low) and photopic.Using a standardized ultrasound protocol, the implants were examined in the middle (point of highest projection) and lateral, by two independent examiners.Image evaluation was performed on anonymized digital images in the PACS. The aim was to achieve an artifact-free recording of the surface structure, the surface coating, the total image structures and, as far as possible, an artifact-free internal representation of the implants.For independent surface evaluation a score was used (0 = undetectability of surface structures, rich in artifacts, 5 = best possible, artifact free image quality).
The quality of ultrasound imaging of breast implant surfaces after the optimization of B-Scan differed significantly comparing high-end ultrasound technology with modern high-frequency ultrasound technology (p < 0,05).The following setting has been found to be the best setting with the highest image quality:B-Mode, SRI value 3, Crossbeam high level with color coded imaging for B- mode. In the total examined frequency range of 6-33 MHz, the highest image quality was found in the average frequency range of 12.5-33 MHz at both measured points. For both devices, device 1 (high-end) and device 2 (high frequency) ultrasound, the image quality was in the12.5-33 MHz frequency range with an average image quality of 3.236. It was significantly higher, than in the lower frequency ranges and the same frequency range with THI. (p < 0,05). The image quality of the high-end sonography device was superior to the conventional high-frequency ultrasound device in all frequency ranges.
High-end ultrasound imaging technology was superior in the quality of implant surface evaluation in comparison to high-frequency ultrasound sonography. The gained knowledge can serve as a basis for further multicenter clinical application and studies with the aim to develop an objective, precise tool to evaluate the implant and the surrounding tissue with ultrasound.
本研究旨在通过比较高端超声技术和新的高频技术，对优化后的乳房植入物表面结构进行评估。本对比研究在体外环境下使用具有不同表面的新型乳房植入物进行。
在一项实验性体外研究中，两位研究者使用两种具有多频换能器的高端超声设备（6-15MHz、9-16MHz、12.5-33MHz）检查了 9 个闲置的硅或聚氨酯（PU）乳房植入物。使用组织谐波成像（THI）、斑点减少成像（SRI，0-5 级）、交叉波束（高、中、低）和光像优化超声 B 模式，然后使用标准化超声协议在两个独立的检查者中间（最高点）和侧面检查植入物。在 PACS 中对匿名数字图像进行图像评估。目的是记录表面结构、表面涂层、总图像结构，并尽可能实现植入物内部的无伪影表示。对于独立的表面评估，使用评分（0=无法检测到表面结构，伪影丰富，5=最佳，无伪影图像质量）。
优化 B 扫描后的乳房植入物表面的超声成像质量在高端超声技术与现代高频超声技术之间有显著差异（p<0.05）。发现以下设置具有最佳的图像质量：B 模式、SRI 值 3、交叉波束高水平和 B 模式的彩色编码成像。在 6-33MHz 的整个检查频率范围内，在两个测量点均在平均频率范围 12.5-33MHz 处发现了最高的图像质量。对于两种设备，设备 1（高端）和设备 2（高频）超声，在 12.5-33MHz 频率范围内的图像质量平均为 3.236，显著高于低频范围和 THI 的相同频率范围。（p<0.05）。高端超声成像设备的图像质量在所有频率范围内均优于传统高频超声设备。
与高频超声相比，高端超声成像技术在植入物表面评估质量方面具有优势。获得的知识可以作为进一步的多中心临床应用和研究的基础，旨在开发一种用于评估植入物及其周围组织的客观、精确的超声工具。
