Ahn C Y, DeBruhl N D, Gorczyca D P, Shaw W W, Bassett L W
Division of Plastic and Reconstructive Surgery, University of California, Los Angeles.
Plast Reconstr Surg. 1994 Oct;94(5):620-7. doi: 10.1097/00006534-199410000-00008.
With the current controversy regarding the safety of silicone implants, the detection and evaluation of implant rupture are causing concern for both plastic surgeons and patients. Our study obtained comparative value analysis of mammography, sonography, and magnetic resonance imaging (MRI) in the detection of silicone implant rupture. Twenty-nine symptomatic patients (total of 59 silicone implants) were entered into the study. Intraoperative findings revealed 21 ruptured implants (36 percent). During physical examination, a positive "squeeze test" was highly suggestive of implant rupture. Mammograms were obtained of 51 implants (sensitivity 11 percent, specificity 89 percent). Sonography was performed on 57 implants (sensitivity 70 percent, specificity 92 percent). MRI was performed on 55 implants (sensitivity 81 percent, specificity 92 percent). Sonographically, implant rupture is demonstrated by the "stepladder sign." Double-lumen implants may appear as false-positive results for rupture on sonography. On MRI, the "linguine sign" represents disrupted fragments of a ruptured implant. The most reliable imaging modality for implant rupture detection is MRI, followed by sonogram. Mammogram is the least reliable. Our study supports the clinical indication and diagnostic value of sonogram and MRI in the evaluation of symptomatic breast implant patients.
鉴于目前关于硅胶植入物安全性的争议，植入物破裂的检测和评估引发了整形外科医生和患者的关注。我们的研究对乳房X线摄影、超声检查和磁共振成像（MRI）在检测硅胶植入物破裂方面进行了比较价值分析。29名有症状的患者（共59个硅胶植入物）纳入了研究。术中发现21个植入物破裂（36%）。体格检查时，阳性“挤压试验”高度提示植入物破裂。对51个植入物进行了乳房X线摄影（敏感性11%，特异性89%）。对57个植入物进行了超声检查（敏感性70%，特异性92%）。对55个植入物进行了MRI检查（敏感性81%，特异性92%）。在超声检查中，植入物破裂表现为“阶梯征”。双腔植入物在超声检查中可能出现破裂的假阳性结果。在MRI上，“细面条征”代表破裂植入物的破碎碎片。检测植入物破裂最可靠的成像方式是MRI，其次是超声检查。乳房X线摄影最不可靠。我们的研究支持超声检查和MRI在评估有症状的乳房植入物患者中的临床指征和诊断价值。
