2017; 02(01): 026-033 pls/16/1620/gmj

Original Article

Contrast Enhanced Ultrasound (Ceus) in Detecting Ruptured Breast Implants Ex Vivo-Preliminary Results of a Unique Technique

Kuehlmann Britta1, 2* M.D., Jung E. M.3 M.D., Clevert Dirk-Andre4 M.D., Dreiner U. Helen5 M.D., Prantl Lukas1 M.D.
1Center for Plastic, Aesthetic, Hand & Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
2Department of Surgery, Hagey Laboratory for Pediatric Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA
3Department of Diagnostic Radiology and Interdisciplinary Ultrasound Department, University Hospital Regensburg, Regensburg, Germany
4Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Grobhadern Campus, Munich, Germany
5epartment of Rheumatology, Slocum Dickson Medical Group, New Hartford, New York, USA

Correspondence to
Kuehlmann Britta Center for Plastic, Aesthetic, Hand & Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany

First Published Online 16 January 2017

ABSTRACT

Introduction: Detection of ruptured breast implants can be challenging, even with MRI. The aim of this study was to examine different breast implants ex vivo with contrast-enhanced ultrasound (CEUS) to determine whether this technique allows screening of implant failure. Objectives: 20 breast implants were examined. Ultrasound was performed using B-mode and CEUS with a multifrequency linear probe after injecting SonoVue to a box filled with NaCl. For interpretation, a scoring system was created (CEUS 1: intact implant, CEUS 5: obvious leakage, called macro-leakage). Results: CEUS was able to detect leakages of all implants, including micro-leakages, verified via microscopy (sensitivity: 100%). Polyurethane (PU) implants with CEUS 2 had a median time of implantation of 14.1 years, silicone implants with CEUS 5 were implanted 3.1 years on average. Silicone implants displayed no significant linear correlation between foreign body capsule formation (Baker score) and CEUS score (correlation coefficient r=0.08). Most of the PU implants with lower Baker grade 3 showed a lower CEUS grade and vice versa, leading to a high correlation (r=0.77). Conclusions: CEUS can be useful to detect implant rupture as an additional method for patients with equivocal sonographic findings. This is a new technique that can help diagnose surface qualities of breast implants.

Keywords: Ultrasound, breast Implants, Ex vivo, Implant Failure, Silicone Implants

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