Study On Long-time Local Tissue Reaction And MRI Diagnosis Of The Complications Of Polyamide Hydrogel Injection For Augmentation Mammoplasty

Objective:The study explored the correlation between clinical symptom,specimen of the tissue,MRI and their relation with long-time after injection to evaluate the safety of this soft tissue filler and the diagnostic and treatment value of MRI for the prophase complications.Methods:From Sep.2004 to Nov.2006,we examined breast tissue samples from a total of 35 women aging from 20 to 47 years who had polyacrylamide hydrogel injected from less than one month to more than six years.They had been undergoing the treatment in our unit. MRI was performed in 35 patients who had breast augmentation with polyacrylamide hydrogel injection.T1WI,T2WI and MRH were all measures in these patients.The results of MRI were compared with the clinical symptoms.Correlation analysis was used to determine the relation among the symptoms ,the specimen of the tissue ,the MRI and the time.Statistical analyses were performed using SAS 8.02 software package for windows.Results :Clinical manifestation:19 patients had clinical symptoms.2 cases occurred in 2years.4 occurred in 2-4 years.The others occurred in 4 years later. Pathology:The normal tissue had thinness peplos,small amounts of phagocytic cells and fibroblasts.There were no inflammatory cells infiltration.16 patients could be seen abnormal pathology.In a patient who was injected for 2 year,there were multinucleated giant cells around the amethyst injectant and other cells were few.3 patients in 2-4 years could be seen slightly hyperplasy of lympholeukocytes and polykaryocytes . There were 12 patients who could be seen hyperplasty of lympholeukocytes and fibroblasts after 4 years' injection.MRI image feature:Normal finding: the PAHG located between the mammary and the pectoral muscle demonstrate well defined water-like long T1 and long T2.0:contour complete with smooth surface.+ : contour complete with fine liner septation.++:contour incomplete with free nodular within mammary.+++:exceeding the mammary or distant immigration.26 people showed abnormal,2 in 2 years,9 in 2-4 years and 15 after 4 years.Conclusions:It should be cautious to the physicians who may apply the product for clinic use.MRI has the great diagnostic value in the detection and management complications after polyamide hydrogel injection for augmentation mammoplasty.