Clinical Imaging Diagnosis of Implant Materials for Breast Augmentation

In Brief Background: The ingredients of substances implanted for breast augmentation sometimes remain unknown due to lack of information from patients. Significant clinical problems sometimes necessitate removal and reconstruction. Thus, preoperative diagnostic imaging to identify the ingredients of implants may improve the treatment decision-making process. In this report, we created a clinical imaging index. Purpose: Here, we summarize computed tomography (CT) and magnetic resonance imaging (MRI) imaging of implant materials to predict the ingredients of implant substances preoperatively. Methods: A total of 104 patients with late complications after receiving breast augmentations between 1971 and 2002 were examined using CT and MRI. In addition, further examinations were conducted, including postoperative chemical analysis using Nuclear magnetic resonance (NMR) spectroscopy and MRI imaging of various implanted substances using an experimental magnetic resonance system. Results: We identified the ingredients of implant materials used for breast augmentation by imaging diagnostics as follows: silicone: radiopaque-low/high (CT-MRI T1/T2); hydrogel: radiolucent-low∼iso/high; hydrocarbon: radiolucent-high∼iso/low∼iso; saline: radiolucent-low/high. Conclusion: We have identified by imaging diagnosis the ingredients of implant materials. Forty-six patients with late complications after breast augmentation underwent CT and MRI examination followed by NMR analysis of explanted material. Successful identification of material in the implants was usually successful preoperatively, although injected material could ordinarily be identified only by NMR following removal.