Akpolat Yusuf T, Dryden Mark J, Scoggins Marion E, Patel Miral M, Yalniz Ceren, Hassid Victor J, Whitman Gary J
Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Department of Radiology Breast Imaging Section, The University of Alabama at Birmingham, Birmingham, AL 35233, USA.
Diagnostics (Basel). 2023 Jun 26;13(13):2173. doi: 10.3390/diagnostics13132173.
Breast implants can be removed with breast explantation surgery (BES) for various reasons, including patient dissatisfaction, capsular contracture, implant infection or rupture, breast implant-associated anaplastic large cell lymphoma, and a recently emerging phenomenon called breast implant illness. There is very limited data on the imaging appearance after BES. A retrospective chart review was performed for patients with BES findings on imaging reports for the period between October 2016 and October 2021. When assessing BES techniques, a key element is determining whether the implant's fibrous capsule requires removal. The second important question is if the patient requires an additional aesthetic procedure after BES. BES techniques include capsulotomy, and partial, total, or en bloc capsulectomy. Adjunctive aesthetic or reconstructive procedures after BES include fat grafting, mastopexy, augmentation, and reconstruction with flaps. The majority of post-BES breast imaging findings are related to the surgical scar/bed, thereby confirming that the type of explantation surgery is important. Imaging findings after BES include focal and global asymmetries, architectural distortions, calcifications, calcified and non-calcified fat necrosis, masses, hematomas, seromas, capsular calcifications, and silicone granulomas. Most importantly, since these patients have residual breast tissue, paying attention to imaging features that are suspicious for breast cancer is necessary.
出于各种原因，可通过乳房假体取出术（BES）取出乳房植入物，这些原因包括患者不满意、包膜挛缩、植入物感染或破裂、乳房植入物相关间变性大细胞淋巴瘤，以及一种最近出现的称为乳房植入物疾病的现象。关于BES术后影像学表现的数据非常有限。对2016年10月至2021年10月期间影像学报告中有BES表现的患者进行了回顾性病历审查。在评估BES技术时，一个关键因素是确定植入物的纤维包膜是否需要切除。第二个重要问题是患者在BES术后是否需要额外的美容手术。BES技术包括包膜切开术，以及部分、全部或整块包膜切除术。BES术后的辅助美容或重建手术包括脂肪移植、乳房上提术、隆乳术和皮瓣重建术。BES术后大多数乳房影像学表现与手术瘢痕/手术床有关，从而证实了假体取出术的类型很重要。BES术后的影像学表现包括局灶性和整体不对称、结构扭曲、钙化、钙化和非钙化脂肪坏死、肿块、血肿、血清肿、包膜钙化和硅酮肉芽肿。最重要的是，由于这些患者仍有残余乳腺组织，因此有必要关注可疑乳腺癌的影像学特征。
