Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, Naples, Italy.
Department Radiology, AOS dei colli Monaldi- Cotugno-CTO, Via L. Bianchi, Naples, Italy.
Radiol Med. 2019 Jun;124(6):568-574. doi: 10.1007/s11547-018-0969-1. Epub 2019 Jan 5.
The purpose of this retrospective study is to evaluate the role of echo-color-Doppler (ECD) imaging in identifying a series of characteristics pursuant to aesthetic filling material such as their degree of absorbability and their potential complications which include their propensity to stimulate the formation of encapsulated foreign-body granulomas. In the latter case, ECD can be of aid by giving indication for surgical therapy.
Over a 4-year period, we studied 180 patients (60 ♂) who underwent an aesthetic medical/surgical treatment. We used ECD to evaluate the implant material, its thickness, the injection site, the integrity of dermal layers and the presence of any associated complications.
In 97% (174/180) of our patients, we were able to identify the type of material used; furthermore, 57% of patients had a hyaluronic acid implant, 14% a lipofilling and 29% a non-absorbable filler (with 10% of silicone). In 6/180 (3%), we could not recognize the material used; 89% (161/180) of our patients presented post-injection complications; moreover, 67% showed peri-implant dermal-hypodermal thickening areas with adjacent lymphostasis, 6% displayed an abnormal implant site, and 17% showed inflammation with encapsulated foreign-body granulomas that required subsequent surgical excision. Biopsy samples were obtained from 37/180 patients (21%); among these, 31 patients had an ECD evidence of granuloma and on 6 patients we were not able to define the injected material. Histopathological examination identified 29 granulomas, 5 sterile abscesses and 3 chronic inflammations in the absence of granuloma. ECD showed an overall 78% diagnostic accuracy, with 90% sensitivity and 37% specificity in detecting filler granulomas.
ECD is a low-cost technique that allows to identify filling materials and to assess the complications of an esthetic medical/surgical treatment.
本回顾性研究旨在评估超声彩色多普勒（ECD）成像在识别一系列特征方面的作用，这些特征包括美容填充材料的可吸收程度及其潜在并发症，包括其诱发包膜异物肉芽肿形成的倾向。在后一种情况下，ECD 可以通过提示手术治疗来提供帮助。
在 4 年期间，我们研究了 180 名患者（60 名男性），他们接受了美容医学/手术治疗。我们使用 ECD 来评估植入材料、其厚度、注射部位、真皮层的完整性以及任何相关并发症。
在我们的 180 名患者中，97%（174/180）能够识别使用的材料类型；此外，57%的患者使用了透明质酸植入物，14%的患者使用了脂肪填充，29%的患者使用了不可吸收的填充物（其中 10%为硅胶）。在 180 名患者中的 6 名（3%），我们无法识别使用的材料；89%（161/180）的患者出现注射后并发症；此外，67%的患者表现为注射部位周围真皮-皮下增厚区域伴有相邻淋巴水肿，6%的患者表现为异常植入部位，17%的患者表现为炎症伴有包膜异物肉芽肿，需要随后进行手术切除。从 180 名患者中的 37 名（21%）获得了活检样本；其中，31 名患者的 ECD 有肉芽肿证据，而 6 名患者我们无法确定注射的材料。组织病理学检查确定了 29 个肉芽肿、5 个无菌脓肿和 3 个无肉芽肿的慢性炎症。ECD 在检测填充物肉芽肿方面的总体诊断准确性为 78%，敏感性为 90%，特异性为 37%。
ECD 是一种低成本技术，可用于识别填充材料，并评估美容医学/手术治疗的并发症。
