Samuels J B, Rohrich R J, Weatherall P T, Ho A M, Goldberg K L
Division of Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas, USA.
Plast Reconstr Surg. 1995 Sep;96(4):865-77. doi: 10.1097/00006534-199509001-00016.
Rupture of a breast implant is a recognized complication of augmentation mammaplasty and reconstructive breast surgery. Due to concerns over the extravasation of silicone gel within adjacent tissue and distant body sites, considerable attention has been given to the radiographic detection of mammary implant rupture. A metaanalysis comparing the accuracy of various currently available imaging modalities was conducted and an algorithm suggested to guide clinicians in the detection of breast implant rupture. Advantages and limitations of mammography, xeromammography, ultrasonography, MRI, and CT are outlined as well as some of the most specific radiographic signs of each with illustrative examples from patients evaluated at our institution. Results of our retrospective analysis corroborated by a review of the most recent literature reveal that mammography supplemented with ultrasonography constitutes the most cost-effective initial study, followed by MRI if these are equivocal. MRI is the most sensitive and specific study to evaluate breast implant rupture.
乳房植入物破裂是隆乳术和乳房重建手术公认的并发症。由于担心硅胶凝胶在邻近组织和远处身体部位外渗，乳房植入物破裂的影像学检测受到了相当多的关注。进行了一项荟萃分析，比较了各种现有成像方式的准确性，并提出了一种算法以指导临床医生检测乳房植入物破裂。概述了乳腺摄影、干板乳腺摄影、超声、MRI和CT的优缺点，以及每种检查最具特异性的影像学征象，并列举了在我们机构接受评估的患者的实例。我们的回顾性分析结果经最新文献综述证实，表明乳腺摄影辅以超声是最具成本效益的初始检查，若结果不明确则接着进行MRI检查。MRI是评估乳房植入物破裂最敏感和特异的检查。
