title: Imaging findings of breast augmentation with injected hydrophilic polyacrylamide gel: patient reports and literature review.
abstract: Hydrophilic polyacrylamide gel (PAAG) is a nonresorbable soft tissue filler that has been used as implant material for breast augmentation in some countries, particularly from the Asian continent. Many complications associated with hydrogel use have been reported in the clinical literature including inflammation, persistent mastodynia, formation of multiple lumps, poor cosmetic results, glandular atrophy, and significant spread of hydrogel into the surrounding tissue. Data on long-term toxicity is currently unavailable. The radiologic features of PAAG injection mammoplasty frequently constitute a diagnostic challenge for radiologists. Indeed, the imaging appearances of uncomplicated PAAG implants may mimic conventional implants on mammography, sonography and MRI, with some distinguishing features. The location and local spread of the injected PAAG, and the eventual detection of local inflammation, are best evaluated by ultrasonography and especially MRI, considered the most sensitive technique for assessment of PAAG mammoplasty. MRI clearly depicts the volume and the distribution of gel within the breast; contrast medium enhancement allows delineation of areas of inflammation and infection. It is important to be familiar with the spectrum of imaging findings in order to make an accurate diagnosis and offer proper management. This paper aims to review the normal and abnormal mammographic, sonographic, and MR imaging characteristics of PAAG augmentation mammoplasty through presented patient reviews of three women having undergone direct PAAG injection.
authors.affiliation: Centre d'Investigation et de Recherche Diagnostique des maladies du sein (CRID), Centre hospitalier de l'Université de Montréal, Hôtel-Dieu, 3840 rue Saint-Urbain, Montréal (Québec), Canada H2W 1T8. nbenkhedher@gmail.com
authors.forename: Najoua Ben
authors.initials: NB
authors.lastname: Khedher
authors.forename: Julie
authors.initials: J
authors.lastname: David
authors.forename: Isabelle
authors.initials: I
authors.lastname: Trop
authors.forename: Suzanne
authors.initials: S
authors.lastname: Drouin
authors.forename: Laurence
authors.initials: L
authors.lastname: Peloquin
authors.forename: Lucie
authors.initials: L
authors.lastname: Lalonde
mesh_terms: D000180:Acrylic Resins / Q000009:adverse effects*; D000328:Adult; D001941:Breast Diseases / Q000139:chemically induced* / Q000175:diagnosis*; D002681:China; D003287:Contrast Media; D005260:Female; D006801:Humans; D007267:Injections; D008279:Magnetic Resonance Imaging; D016462:Mammaplasty / Q000009:adverse effects*; D008327:Mammography; D016896:Treatment Outcome; D016217:Ultrasonography, Mammary
chemical_list: D000180:Acrylic Resins; D003287:Contrast Media; C016680:polyacrylamide gels