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1.
We present the FDG PET images of a 60-year-old woman with a history of breast cancer, bilateral mastectomy, and reconstruction 4 years ago who presented for a whole-body scan to evaluate for recurrent and metastatic disease. The images showed inflammatory FDG activity around the ruptured left breast prosthesis likely in response to the leaking prosthesis. The patient underwent surgery for the replacement of the prosthesis, which did not show any evidence of neoplastic disease.  相似文献   

2.
目的探讨保留皮肤的乳腺癌改良根治术Ⅰ期假体植入乳房重建的可行性。方法对15例Ⅰ、Ⅱ期乳腺癌患者行保留皮肤的乳腺癌改良根治术后,同期于胸大、小肌间植入硅胶假体重建乳房。结果保留乳头乳晕复合体5例,不保留乳头乳晕复合体10例,术后随访5~27个月,术后外观良好,双侧乳房对称,优良率达97%。所有病例均无局部复发或远处转移。结论保留皮肤的乳腺癌改良根治术后用硅胶假体行即刻乳房重建,具有操作方便、效果明显,是安全可行的手术方法。  相似文献   

3.
目的:探讨聚丙烯酰胺水凝胶(PAAG)注射隆乳后并发症、MRI表现、组织病理学变化与注入时间的关系.方法:选取PAAG隆乳术后要求取出假体的35例个体(70只乳房假体)为研究对象,注入时间1周~6年,按注入时间分为2年以内组(n=7),2~4年组(n=11),4~6年组(n=17) 3组.以术前乳房触诊结果记录各组临床...  相似文献   

4.
OBJECTIVE: This article reviews the multimodality imaging features of breast augmentation complications as well as appearances of unusual breast augmentation techniques. CONCLUSION: Cosmetic breast augmentation is an increasingly common procedure performed in our society. Although breast prosthesis implantation is the most common technique, other unusual techniques such as autologous fat implantation as well as direct liquid silicone and paraffin injections have also been used.  相似文献   

5.
核医学乳腺专用显像仪在乳腺癌诊疗中的应用   总被引:1,自引:0,他引:1  
核医学乳腺专用显像仪包括乳腺专用伽玛射线显像(BSGI)和正电子发射乳腺显像(PEM)仪,两者分辨率高,不受乳腺组织密度、假体植入、瘢痕形成等因素的影响,可以诊断直径仅为3mm的病灶。笔者综述了BSGI和PEM在乳腺癌早期诊断、治疗方案选择以及疗效评价等方面的应用。  相似文献   

6.
Breast implant rupture can be difficult to diagnosis. Various modalities including direct clinical palpation, ultrasound, CT, and mammography have been used to evaluate for the presence of prosthesis rupture. We report a case in which the presence of breast implant rupture was determined using MR with characterization of the inflammatory reaction in the soft tissues around the implant. The absence of ionizing radiation with MR makes it especially well suited for evaluating implant rupture in younger patients in whom breast irradiation should be minimized.  相似文献   

7.
The purpose of this study was to assess the diagnostic accuracy of MRI in detecting prosthesis integrity and malignancy after breast augmentation and reconstruction. Forty-one implants in 25 patients were analyzed by MRI before surgical removal. Imaging results were compared with ex vivo findings. Magnetic resonance imaging of the breast was performed on a 1.5-T system using a dedicated surface breast coil. Axial and sagittal T2-weighted fast spin-echo as well as dynamic contrast-enhanced T1-weighted gradient-recalled-echo sequences were acquired. The linguine sign indicating collapse of the silicone shell or siliconomas indicating free silicone proved implant rupture, whereas early focal contrast enhancement of a lesion was suspicious for malignancy. The sensitivity for detection of implant rupture was 86.7% with a specificity of 88.5%. The positive and negative predictive values were 81.3 and 92.0%, respectively. The linguine sign as a predictor of intracapsular implant rupture had a sensitivity of 80% with a specificity of 96.2%. Magnetic resonance imaging revealed two lesions with suspicious contrast enhancement (one carcinoma, one extra-abdominal fibromatosis). Magnetic resonance imaging is a reliable and reproducible technique for diagnosing both implant rupture and malignant lesions in women after breast augmentation and reconstruction.  相似文献   

8.
Breast carcinoma is the most common neoplasm found among women in the Western world. Mammography (MM) is the most widely used diagnostic imaging method for screening and diagnosing breast cancer. However, despite technical improvements in recent years, MM has known diagnostic limits; consequently not all breast carcinomas are identified on mammograms, especially if the breast is dense, there is a breast prosthesis or the patient has previously undergone radiation, surgery or biopsy. In addition, the mammographic images of benign and malignant lesions can be similar. Therefore, abnormalities detected on MM frequently result in negative biopsies. Scintimammography (SM) is the functional imaging study of the breast using primarily the radiopharmaceuticals (99m)Tc-sestamibi and (99m)Tc-tetrofosmin. The main advantage of SM is that its functional basis makes this technique a useful complement to MM. SM resolves some of the main limitations of MM as it is not affected by changes in breast morphology. Several single-site and multi-centre studies have demonstrated that SM has an improved specificity compared with MM, because it is better able to distinguish malignant from benign breast lesions. Interestingly, except in smaller lesions, a higher sensitivity has been recorded for SM than for MM in most of these studies as well. Adjunctive use of SM when MM is equivocal can reduce the number of unnecessary breast biopsies and identify previously unexpected sites of breast cancer. SM appears unaffected by the anatomical changes seen following chemotherapy and radiotherapy, and so this technique can be particularly useful in monitoring the treatment of breast cancer patients, especially when breast-conserving treatment is given. The main limitation to SM has been the sub-optimal resolution of the standard Anger gamma camera, which makes it difficult to detect lesions of less than 10 mm; however, the development of high-resolution breast-dedicated gamma cameras may offer improvements in this respect. This review will look at the evidence for SM and show how it can become part of the clinical care algorithm in breast cancer.  相似文献   

9.
This study was conducted to longitudinally compare a new floating platform mobile-bearing (MB) prosthesis with an established fixed-bearing (FB) system with respect to early clinical outcomes in patients with bilateral TKAs using the MB prosthesis in one knee and the FB prosthesis in the other. Clinical outcomes (ROM, AKS and WOMAC scores, and side preference), evaluated at 6, 12 and 24 months postoperatively, were compared between knees fitted with the MB prosthesis (e.motion-FP) or the FB prosthesis (Genesis II) in 66 patients who underwent bilateral TKA. In addition, the same comparisons between the knees fitted with the MB prosthesis and the knees with the FB prosthesis were made separately in the subgroup of 33 patients implanted with a cruciate retaining FB (FB-CR) prosthesis and the other subgroup of 33 patients with a posteriorly stabilized FB (FB-PS) prosthesis in a knee. The floating platform MB prosthesis achieved comparable clinical outcomes to the FB prosthesis. No significant differences were found between the FB- and MB-implanted sides at any time with respect to the outcome scales, and temporal patterns were similar. However, comparisons of FB-CR and FB-PS patient groups revealed different temporal patterns. In the FB-CR group, most outcome scales were improved at 6 months, peaked at 12 months and then remained at this level at 24 months. In contrast, outcomes in the FB-PS group improved much faster to almost peak at 6 months, and then remained at this level. In the FB-CR group, more patients preferred the knee with fitted with a MB prosthesis at 6 months. In contrast, in the FB-PS group, no side preference for the MB prosthesis was observed, and more patients preferred knees implanted with the FB prosthesis at 12 and 24 months. This study demonstrates that this new mobile-bearing prosthesis, designed as a floating platform, provides satisfactory clinical performances that are comparable to those achieved using the established fixed-bearing prosthesis in terms of clinical outcomes.  相似文献   

10.
Meniscus replacement by a polymer meniscus prosthesis in dogs resulted in generation of new meniscal tissue. HYPOTHESIS: Optimal functioning of the prosthesis would involve realistic deformation and motion patterns of the prosthesis during knee joint motion. STUDY DESIGN: Controlled laboratory study. METHODS: The movements of the meniscus were determined during knee joint flexion and extension with and without internal and external tibial torque by means of roentgen stereophotogrammetric analysis. Subsequently, the meniscus in 6 human cadaveric knee joints was replaced by a meniscus prosthesis. RESULTS: All different parts of the meniscus showed a posterior displacement during knee joint flexion. The anterior horn was more mobile than the posterior horn. The prosthesis mimicked the movements of the meniscus. However, the excursions of the prosthesis on the tibial plateau were less. The knee joint laxity was not significantly higher after replacement with the meniscus prosthesis. CONCLUSIONS: The prosthesis approximated the behavior of the native meniscus. Improvement in both the gliding characteristics of the prosthetic material and the fixation of the prosthesis may improve the function. CLINICAL RELEVANCE: The meniscus prosthesis needs to be optimized to achieve a better initial function in the knee joint.  相似文献   

11.
MRI对隆乳手术术后患者的诊断价值   总被引:1,自引:0,他引:1  
曹毅媛  夏黎明  饶晶晶  杜烜 《放射学实践》2007,22(12):1256-1258
目的:探讨隆乳术后并发症MRI影像学特征及不同影像技术的诊断价值.方法:对32例63只隆乳术后出现症状的乳房行1.5T MRI平扫、3D FSE脂肪抑制水成像及VIBRANT动态增强扫描.结果:本组28例55只乳房行注射式水凝胶隆乳术,47只假体外漏,双乳不对称4例,1例2只为感染,1例1只为假体内出血,3例3只为腺体病变.1例行双侧乳房内自体脂肪注射术,乳房下部可见较多脂肪团块.3例行双侧乳房硅胶假体植入术,1例1只盐水假体变形,1例1只硅凝胶假体外漏.上述影像学表现均与取出术中结果相符.结论:MRI对诊断隆乳术后外漏并发症有着重要的价值,VIBRANT序列有助于诊断感染及腺体病变,3D FSE脂肪抑制水成像序列对水凝胶和硅胶盐水假体的整体显示有显著的优势.  相似文献   

12.
The incidence of local recurrence after surgery for retroperitoneal sarcoma is reduced by high-dose adjuvant radiotherapy but treatment is restricted by the effects of irradiation on adjacent viscera. By securing a silicone gel-filled implant (breast prosthesis) in the tumour bed after excision of the tumour, adjacent viscera are displaced from the site of maximum irradiation and may thereby be protected. We used this technique in three patients in whom excision of a retroperitoneal sarcoma was followed by high-dose adjuvant radiotherapy. Post-operative radiotherapy was well tolerated but local recurrence developed in one patient, and delayed perforation of the large bowel occurred in another. Both cases underwent further surgery at which the implant was removed. The same two cases also developed asymptomatic hydronephrosis on the side of the implant, attributed to local fibrosis.  相似文献   

13.

Purpose

The aim of this study was to evaluate treatmentrelated complications, outcomes, and patient satisfaction in women with locally advanced breast cancer who received post-mastectomy radiation therapy (PMRT) after breast reconstruction (BR).

Materials and methods

Between October 2007 and November 2010, 46 patients with locally advanced breast cancer who underwent mastectomy followed by BR received PMRT at our Department. Radiotherapy was delivered to the chest wall with a dose of 50 Gy in 25 fractions over 5 weeks.

Results

The median follow-up was 19 months. Skin erythema grade 1 and 2 was seen in 44 (96%) and two (4%) patients, respectively. Major complications, requiring additional corrective surgical procedure, occurred in three (7%) patients (one patient with prosthesis, one patient with tissue expander and one patient with deep inferior epigastric perforator flap). At univariate analysis, smoking, chemotherapy, hormone therapy with tamoxifen and reconstruction with implant were associated with overall complications (capsular contracture and reconstruction failure). Forty (86%) patients were very satisfied or satisfied with the cosmetic outcome of reconstruction.

Conclusions

Radiotherapy can be safely delivered after BR, with a low complication rate and good patient satisfaction. Further randomised studies are needed to better define the optimal timing of breast reconstruction and post-mastectomy radiation therapy.  相似文献   

14.

Background and purpose

Radiotherapy (RT) of reconstructed breasts was associated with major complications and poor cosmetic outcome. The present study assessed complication rates, the link between risk factors and prosthesis removal, as well as cosmetic outcomes.

Patients and methods

From 1997 to 2009, 101 consecutive patients received RT after breast reconstruction because of risk factors for relapse (92) or because relapse had occurred (9). At RT, 90 patients had temporary tissue expanders and 11 had permanent implants. Twelve patients underwent neo-adjuvant chemotherapy; all patients received adjuvant chemo- and/or hormone therapy.

Results

At a median follow-up of 50?months, late toxicities occurred in 28 patients: pain in 7, lymphedema in 6, G1 cutaneous toxicity in 5, and subcutaneous toxicity in 19 (2G1, 9G2, 7G3, 1G4), with more than one side effect in 12. In 8?patients the prosthesis ruptured (3), was displaced (3), was displaced and ruptured (1), or lost shape (1). Capsular contracture was classified in 89 patients as IA in 14, IB in 47, II in 10, III in 11, and IV in 7. Twelve prostheses (11.9%) were removed. The only significant factor for prosthesis removal was age (p?=?0.007). Judgments of cosmetic results were available from 81 physicians and 84 patients. Outcome was excellent/good in 58/81 physician judgments and in 57/84 patient evaluations. Overall inter-rater agreement on outcome was good (??-value 0.64; 95% CI: 0.48?C0.79).

Conclusion

RT to reconstructed breasts was associated with low rates of late toxicity and prosthesis removal. Cosmetic outcomes were, on the whole, good to excellent.  相似文献   

15.
We have used 29Si solid-state nuclear magnetic resonance (NMR) spectroscopy to study the chemical structure of the silicone gels in virgin and explanted breast prostheses. Despite evidences of alteration in the morphological appearance of the silicone gel inside the breast prosthesis, our results do not reveal changes in the chemical nature and structure of the silicone gels after implantation. In addition to the main 29Si resonance peak at ?22.26 ppm that corresponds to the resonance frequency of the D repeat unit of the polysiloxane chains, the high sensitivity of our NMR technique allows the detection of very low concentrations of silicone compounds. Within our experimental detection limit of 0.2%, no signal between ?90 ppm and ?150 ppm are observed. This indicates that no silica products are present inside the gel of the prostheses. Furthermore, our 29Si NMR spectra indicate differences in the chemical compositions of the silicone gels from different manufacturers.  相似文献   

16.
A meniscal prosthesis made of Dacron with polyurethane coating was tested as a substitute for the medial meniscus in a rabbit experimental model concentrating on biomechanical behavior of the knee joint and gross and histologic evaluation 3 months after surgery. The results were compared to sham-operated knees, knees with a peripheral incision of the medial meniscus, and knees with a total meniscectomy. Knees with prosthesis implantation had the same stiffness as knees with sham-operation or meniscal incision, but knees with meniscectomy were stiffer (P less than 0.05). Knees with prosthesis showed lower energy storage during relaxation than knees with sham-operation or meniscal incision (P less than 0.05). Energy storage in the prosthesis group was similar to the meniscectomy group. Partial or total ingrowth of synovial tissue into the prosthesis was present in 93%, and 63% of the incised menisci had healed. Cartilage changes were present in 70% of the prosthesis group, in 25% of the knees with meniscal incision, and in all knees with meniscectomy. The sham-operated knees were free from cartilage degeneration. Knees with prosthesis had the same frequency of cartilage changes on the femur, but had less changes on the tibia compared to knees with meniscectomy. A high rate of osteophyte formation was observed after prosthesis implantation as well as following meniscectomy, but the osteophytes were larger in the prosthesis group (P less than 0.01). The most frequent and severe effect on the synovium was found in the prosthesis group (92%), but no foreign body reaction or loose Dacron particles were found.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

17.
目的针对老年人股骨颈骨折后假体置换术,使用有限元分析的方法对股骨短柄假体与常规股骨假体的生物力学特性进行对比。方法利用薄层CT资料建立股骨三维有限元模型,利用我院股骨中空多孔股骨假体相关参数建立两种髋关节股骨假体三维有限元模型;应用Ansys 5.7有限元分析软件考察两种假体植入后的应力分布,并进行比较。结果短柄假体所受最大mises应力较常规股骨假体明显减小;力学传导模式仍为远端应力集中,最大mises应力仍出现在张力侧。结论老年人股骨颈骨折关节置换术中短柄假体力学特性优越。  相似文献   

18.
《Medical Dosimetry》2021,46(3):212-218
The aim of this study was to investigate prostate radiotherapy techniques for the patients with hip prosthesis in 4 different field setups. Volumetric Modulated Arc Therapy (VMAT) technique was used in 4 different cases: (1) using full VMAT arcs (VMAT_F); (2) same arcs as in case 1 but with avoidance sectors (VMAT_ASEC); (3) as case 2 but with the addition of a lateral static field through the prosthesis (VMAT_ASEC+STAT); (4) as in case 1 but with an automated structure avoidance option to avoid irradiation through the prosthesis (VMAT_ASTR). Fifteen previously treated prostate patients were retrospectively selected to this study. Treatment plans were created for all patients using all 4 techniques. The potential prosthesis misalignment in the treatment setup was modeled by moving the prosthesis 0.5, 1.0, and 1.5 cm ventrally and dorsally and recalculating the plans in each case. For VMAT_ASEC, the dose parameters for organs at risk were the highest and the dose coverage of the target volume was the poorest when compared to the other techniques. For VMAT_ASEC+STAT, the movement of the prosthesis changed the target dose distribution the most. VMAT_F and VMAT_ASTR fulfilled the planning criteria the best, even when the prosthesis was misaligned. VMAT_F radiated through the prosthesis more than VMAT_ASTR and increased the dose near the prosthesis surface when compared to VMAT_ASTR. VMAT_ASTR and VMAT_F were the most robust techniques for the patients with the hip prosthesis considering plan quality and the effect of positioning errors. The increased prosthesis surface dose with VMAT_F and possible dose calculation uncertainties favors the use of VMAT_ASTR.  相似文献   

19.
A patient with a total laryngectomy and tracheoesophageal voice prosthesis presented with tracheobronchial aspiration of a Phillips-head screw that was swallowed inadvertently and aspirated around a loose-fitting prosthesis. A modified esophagram showed a screw in the right lung and free leakage of barium from the cervical esophagus around the prosthesis into the tracheobronchial tree. Chest radiographs and CT confirmed a screw in a right lower lobe bronchus with postobstructive pneumonia. When this complication occurs, it is important to extract the foreign body and, if necessary, to adjust or remove the prosthesis to prevent future aspiration pneumonias or foreign body aspiration.  相似文献   

20.
The Angelchik antireflux prosthesis is a silicon gel-filled, doughnut-shaped device with a tantalum tie strap that wraps around the gastroesophageal junction after reduction of a hiatal hernia. If dislodged, this prosthesis may produce a confusing picture on computed tomography, as it is of soft tissue density and may mimic a mass lesion. The computed tomography appearance of a normally placed prosthesis is demonstrated, and a case of prosthesis dislodgment diagnosed by computed tomography is reported.  相似文献   

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