MRI三维重建技术在面部注射填充物取出中的临床应用

Clinical Application of MRI Three-dimensional Reconstruction in Removal of Facial Injectable Fillers

目的探讨MRI三维重建技术在取出面部注射填充物中的临床应用。方法2019年12月至2020年6月共收治28例面部注射填充术后患者,患者主诉以局部结节、肿胀变形、疼痛为主。所有患者术前行MRI三维重建检查,分析注射物的量、位置及层次,根据影像学结果将切口设计于发际线、鼻孔缘、口腔内等较隐蔽处,行注射物取出术,术后3个月行MRI三维重建检查,观察治疗效果。结果本组中有1例患者术后出现伤口感染,经局部换药后愈合,其余患者术后伤口均一期愈合。术后3个月MRI三维重建检查,26例无明显软组织填充剂残留,另2例有局部残留,二次手术后无明显软组织填充剂残留。本组28例患者对术后效果表示满意。结论MRI三维重建技术可以辅助分析注射物的性质及分布范围,进行良好的术前评估,结合患者的症状及查体情况,综合设计手术方案,对术中取出面部注射物有极大的益处,值得临床推广。

Objective To explore the clinical application of removing the facial injectable fillers with the assistance of MRI three-dimensional reconstruction.Methods From December 2019 to June 2020,a total of 28 cases with facial injectable fillers were treated.The chief complaints included local nodules,swelling,and pain.To analyze the amount,position and layer of fillers,all patients were invited to take preoperative MRI three-dimensional reconstruction.Based on the images,relevant operations were designed to remove fillers from hidden places such as the hairline,nostril margin,and oral cavity.Three months after operation,MRI three-dimensional reconstruction was performed to observe the treatment effect.Results After the operation,all patients'wounds were in one stage suture.One patient developed wound infection but healed after local dressing change.Three months after operation,the follow-up MRI three-dimensional reconstruction showed there was no obvious residual filler in 26 out of 28 cases.The other two patients who still had local residuals were performed a second operation and reexamined through MRI three-dimensional reconstruction.The result showed no obvious fillers in the end.The 28 patients were all satisfied with the postoperative effect.Conclusion With the help of MRI three-dimensional reconstruction,the property and distribution area of fillers can be firstly well analyzed,after which,a good preoperative evaluation of facial injectable fillers could be carried out.Combining the patient's symptoms and physical examination,a comprehensive surgical plan could be made to remove facial injectable fillers.This method is of great help to the removal of facial injectable fillers during surgery,which is worthy of clinical application.