Monticciolo D L, Nelson R C, Dixon W T, Bostwick J, Mukundan S, Hester T R
Department of Radiology, Emory University School of Medicine, Atlanta, GA 30322.
AJR Am J Roentgenol. 1994 Jul;163(1):51-6. doi: 10.2214/ajr.163.1.8010247.
The purpose of this study was to determine the value of MR imaging with a silicone-selective pulse sequence for detecting leakage from silicone breast implants.
Women with silicone breast implants were referred for this study on the basis of clinical or imaging findings suggestive of implant rupture. Twenty-eight patients with 38 implants were examined with silicone-selective MR imaging and also underwent surgical removal of the studied implant. All but four also had mammography before MR imaging. Results of silicone-selective MR imaging for the detection of silicone leakage were compared with mammographic and surgical findings. Surgical proof was considered the gold standard.
Silicone-selective MR imaging showed an apparently intact implant in 21 cases; 20 of these were found to be intact at surgery. Silicone-selective MR imaging showed evidence of leakage in 17 implants, all of which showed leakage at surgery. The sensitivity for detection of leakage was 94%; the specificity was 100%. The findings of silicone-selective MR imaging and mammography were in agreement in 30 of 34 cases in which both studies were performed. In the four cases of disagreement, surgical findings agreed with MR findings in three and with mammographic findings in one. When the findings of mammography and silicone-selective MR imaging were combined, the correct status (leakage or no leakage) of all implants examined was determinable.
Silicone-selective MR imaging is highly effective for detecting leakage from silicone breast implants. Accuracy is improved when mammographic and MR findings are considered together.
本研究旨在确定采用硅胶选择性脉冲序列的磁共振成像（MR成像）在检测硅胶乳房植入物渗漏方面的价值。
基于提示植入物破裂的临床或影像学表现，将有硅胶乳房植入物的女性纳入本研究。对28例患者的38个植入物进行了硅胶选择性MR成像检查，并对所研究的植入物进行了手术切除。除4例患者外，其余所有患者在MR成像前均进行了乳腺X线摄影。将硅胶选择性MR成像检测硅胶渗漏的结果与乳腺X线摄影及手术结果进行比较。手术结果被视为金标准。
硅胶选择性MR成像显示21例植入物外观完整；其中20例在手术中发现完整。硅胶选择性MR成像显示17个植入物有渗漏迹象，所有这些植入物在手术中均显示有渗漏。检测渗漏的敏感性为94%；特异性为100%。在同时进行两项检查的34例病例中，硅胶选择性MR成像和乳腺X线摄影的结果在30例中一致。在4例不一致的病例中，手术结果在3例中与MR成像结果一致，在1例中与乳腺X线摄影结果一致。当将乳腺X线摄影和硅胶选择性MR成像的结果结合起来时，所有检查的植入物的正确状态（渗漏或无渗漏）均可确定。
硅胶选择性MR成像在检测硅胶乳房植入物渗漏方面非常有效。将乳腺X线摄影和MR成像结果综合考虑可提高准确性。
