MRI in the evaluation of facial dermal fillers in normal and complicated cases

M, Di Girolamo; Mattei, Mauro; Signore, Alberto; Grippaudo, Francesca Romana

doi:10.1007/s00330-014-3513-2

Cited by 36 publications

(41 citation statements)

References 41 publications

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“…There are other types of facial filler substances on the market than are represented in the sample, and we have not yet had the opportunity to characterize them using our novel MRI technique. Several non-face dedicated techniques have been published in the literature [5, 7], and we did not perform a randomized trial to compare our technique to others; however, the robustness of the Dixon sequences used, which include fat suppression and high resolution field of view, alongside the added value of gadolinium injection, serves as a precise and accurate all-encompassing facial imaging technique. The imaging and clinical utility of this technique was highlighted by our high inter-rater statistics and exquisite images.…”

Section: Discussionmentioning

confidence: 99%

“…Generally speaking, shorter-term products have greater biocompatibility [4]. Depending on the type of filler used, complication rates range from 3 % to 52 % [5]. In the short term, adverse events can include bleeding, infections, edema, and migration.…”

Section: Introductionmentioning

confidence: 99%

“…However, these descriptions are only useful when the identity of the filler is known and there is simply a need for visualization. Girolamo et al showed that granulomatous reactions to fillers produced subcutaneous contrast enhancement with IV gadolinium, and found that MRI could be used to detect dermal fillers down to a minimum size of 2 mm without reliance on clinical evaluation [5]. Kadouch et al assessed the extent of agreement between clinical evaluations of injectable filler-related complications and an independent MRI evaluation [10], and found good concordance in uncomplicated cases (85 %), but not in cases with inflammation or migration (32 and 9 %, respectively).…”

Section: Introductionmentioning

confidence: 99%

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MRI in detecting facial cosmetic injectable fillers

et al. 2016

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BackgroundDespite being considered a non-invasive procedure, injections can cause adverse outcomes including infections, overfilling, asymmetry, foreign body granulomas, and reactions that lead to scarring. Complications may be associated with the procedure itself, the physician’s technique, and/or the type of agent injected. In these instances, it is important to be able locate and identify the substance used. This study investigated the viability of using MRI to correctly identify injected substances, their symmetry of distribution, and related complications.MethodsFourteen patients with suspected injectable filler complications were identified by our institution’s plastic surgery service. All subjects were scanned with MRI, using highly specific face-oriented sequences at high resolution with small field of view and thin slices across the axial and coronal planes by T1 Dixon non-contrast, T2 Dixon, and T1 Dixon after gadolinium injection. Two independent and blinded radiologists evaluated the images and reported (1) the likely injected substance, (2) symmetry, and (3) complications. These radiological results were compared against clinical data provided by the plastic surgery service.ResultsTen patients (83 %) presented objective injectable complications: 4 had abscess, 4 granulomata, and 2 had allergic reactions to the injected substance. The Fleiss Kappa for inter-rater agreement on substances was 0.80. Asymmetry was identified in six patients (50 %) with a Kappa between radiology evaluators of 1. MRI characteristics of these common fillers are summarized in table form.ConclusionsGiven the growing awareness among referring physicians of the value of dedicated facial MRI, utilization of this imaging technique may lead to discovery of the injected substance’s true identity, evaluation of symmetry and/or complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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MRI in detecting facial cosmetic injectable fillers

et al. 2016

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“…The information obtained from Dynamic Contrast Enhancement (DCE) T1-weighted MR images have also been used to monitor angiogenesis over time within implanted constructs. However, most of the studies were performed in rabbits 5–7 , large animals 8–11 and patients 12 , so as to limit voxel size and consequently shorten acquisition time. The spatial resolution has to be improved in small animals, like rats, as the structures are smaller.…”

Section: Introductionmentioning

confidence: 99%

3D anatomical and perfusion MRI for longitudinal evaluation of biomaterials for bone regeneration of femoral bone defect in rats

Ribot

Tournier

Aid‐Launais

et al. 2017

Sci Rep

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Magnetic Resonance Imaging (MRI) appears as a good surrogate to Computed Tomography (CT) scan as it does not involve radiation. In this context, a 3D anatomical and perfusion MR imaging protocol was developed to follow the evolution of bone regeneration and the neo-vascularization in femoral bone defects in rats. For this, three different biomaterials based on Pullulan-Dextran and containing either Fucoidan or HydroxyApatite or both were implanted. In vivo MRI, ex vivo micro-CT and histology were performed 1, 3 and 5 weeks after implantation. The high spatially resolved (156 × 182 × 195 µm) anatomical images showed a high contrast from the defects filled with biomaterials that decreased over time due to bone formation. The 3D Dynamic Contrast Enhanced (DCE) imaging with high temporal resolution (1 image/19 s) enabled to detect a modification in the Area-Under-The-Gadolinium-Curve over the weeks post implantation. The high sensitivity of MRI enabled to distinguish which biomaterial was the least efficient for bone regeneration, which was confirmed by micro-CT images and by a lower vessel density observed by histology. In conclusion, the methodology developed here highlights the efficiency of longitudinal MRI for tissue engineering as a routine small animal exam.

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“…Although injection of fillers is a minimally invasive procedure, it does not come without complications. Echymosis, infections, edema, and unsatisfactory esthetic outcomes are common complications of filler injections [2] . Skin necrosis, which is secondary to vascular compromise, is a rare but stressful complication of filler injections, and is more likely to result in permanent sequelae.…”

mentioning

confidence: 99%