Zegzula H D, Lee W P
Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Ann Plast Surg. 2001 Jan;46(1):46-8. doi: 10.1097/00000637-200101000-00009.
Tissue expanders are placed routinely for breast reconstruction, and magnetic resonance imaging (MRI) is a common diagnostic procedure. Many studies have reported on the safety of MRI in patients with nonferromagnetic implants; however, many tissue expanders contain ferromagnetic components. The authors present a case of bilateral tissue expander infusion port dislodgment after MRI. A 56-year-old woman underwent bilateral mastectomy and immediate reconstruction with McGhan BIOSPAN tissue expanders. These implants contain integral nonferromagnetic infusion ports, as well as small, powerful Magna-Site magnets. Several weeks postoperatively the patient underwent MRI of her spine, which was ordered by her primary physician for back pain. Subsequently, the infusion ports could not be located with the finder magnet. A chest radiograph was obtained, which demonstrated bilateral dislodgment of the infusion ports. Surgical removal and replacement of the tissue expanders were required. Safety considerations of MRI have been discussed extensively in the literature, and data on MRI with various implanted devices have been obtained. The potential risks of performing MRI on patients with metallic implants include conduction of electrical currents, heating of the implant, misinterpretation resulting from artifact, and the possibility of movement or dislodgment of the implant. The small magnet integral to many tissue expanders may be overlooked by patients and physicians during pre-MRI screening. All patients undergoing tissue expansion with implants that contain integral ports should be thoroughly warned about the potential hazards of MRI.
组织扩张器常用于乳房重建,磁共振成像(MRI)是一种常见的诊断方法。许多研究报告了MRI在非铁磁性植入物患者中的安全性;然而,许多组织扩张器含有铁磁性成分。作者报告了一例MRI后双侧组织扩张器输注端口移位的病例。一名56岁女性接受了双侧乳房切除术,并立即用麦加恩BIOSPAN组织扩张器进行重建。这些植入物包含一体式非铁磁性输注端口以及小而强的Magna-Site磁铁。术后几周,患者因主治医生为其背部疼痛而安排进行了脊柱MRI检查。随后,用探测磁铁无法找到输注端口。拍摄了胸部X光片,显示输注端口双侧移位。需要手术取出并更换组织扩张器。MRI的安全考虑在文献中已有广泛讨论,并且已经获得了关于各种植入装置的MRI数据。对金属植入物患者进行MRI的潜在风险包括电流传导、植入物发热、伪影导致的误诊以及植入物移动或移位的可能性。许多组织扩张器所包含的小磁铁在MRI检查前的筛查过程中可能会被患者和医生忽视。所有接受含一体式端口植入物组织扩张的患者都应被充分告知MRI的潜在危害。