Significance of MRI before surgery to remove polyacrylamide hydrogel used for augmentation mamma-plasty / 中华医学美学美容杂志

ABSTRACT

Objective To evaluate the significance of MRI before surgery to remove polyaeryl-amide hydrogel (PAMHG) which has been used for augmentation mammaplasty. MethodsTwenty female patients with 40 breasts, having been injected PAMHG as augmentation mammaplasty, under-went bilateral breast axial T1WI, T2WI-fat saturation (FS) and sagittal T2WI-FS by 4-channal phased-assay breast coil at 3.0T (Philips) before removal surgery, in which 8 patients underwent axial multiphase contrast-enhanced MRI with THRIVE after Gd-DTPA (2.0 ml/s, 0.1 mmol/kg) adminis- tration. The results of MRI were compared with that of operation and pathology. ResultsPAMHG showed iso-intensity compared with breast gland on T1WI and hyperintensity on T2WI-FS. Low signal septa were noted within PAMHG in 40 breasts (20 patients), 90% (36/40) PAMHG without capsule, 10 % (4/40) with smooth capsule which showing homogenous low signal on T1WI and T2WI-FS. Subcutaneous lump of PAMHG was 70 % (28/40), lump of that in breast gland was 20% (8/40). Diffuse gel along spatium intermusculare of pectoralis major was 100 % (40/40), that along spatium intermusculare of intercostal muscle was 10 % (4/40). All PAMHG in breast of the 8 patients showed no enhancement, an irregular enhanced mass was found in gland of 1 patient. All distributions of PAMHG and appearances of its complications on T2WI-FS were consistent with the results of operation. ConclusionsT2WI-FS can accurately display the distribution of PAMHG and its complication before removal surgery. MRI plane scan combined with muhiphase contrast-enhanced MRI can differentiate PAMHG from the lesions in the gland and find the breast carcinoma, so that it can guide clinicians before surgery to remove PAMHG used for augmentation mammaplasty.