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Injectable facial fillers: imaging features, complications, and diagnostic pitfalls at MRI and PET CT

ABSTRACT: Injectable fillers are widely used for facial rejuvenation, correction of disabling volumetric fat loss in HIV-associated facial lipoatrophy, Romberg disease, and post-traumatic facial disfiguring. The purpose of this article is to acquaint the reader with the anatomy of facial fat compart...

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Autores principales: Mundada, Pravin, Kohler, Romain, Boudabbous, Sana, Toutous Trellu, Laurence, Platon, Alexandra, Becker, Minerva
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707222/
https://www.ncbi.nlm.nih.gov/pubmed/28980212
http://dx.doi.org/10.1007/s13244-017-0575-0
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author Mundada, Pravin
Kohler, Romain
Boudabbous, Sana
Toutous Trellu, Laurence
Platon, Alexandra
Becker, Minerva
author_facet Mundada, Pravin
Kohler, Romain
Boudabbous, Sana
Toutous Trellu, Laurence
Platon, Alexandra
Becker, Minerva
author_sort Mundada, Pravin
collection PubMed
description ABSTRACT: Injectable fillers are widely used for facial rejuvenation, correction of disabling volumetric fat loss in HIV-associated facial lipoatrophy, Romberg disease, and post-traumatic facial disfiguring. The purpose of this article is to acquaint the reader with the anatomy of facial fat compartments, as well as with the properties and key imaging features of commonly used facial fillers, filler-related complications, interpretation pitfalls, and dermatologic conditions mimicking filler-related complications. The distribution of facial fillers is characteristic and depends on the anatomy of the superficial fat compartments. Silicone has signature MRI features, calcium hydroxyapatite has characteristic calcifications, whereas other injectable fillers have overlapping imaging features. Most fillers (hyaluronic acid, collagen, and polyalkylimide–polyacrylamide hydrogels) have signal intensity patterns compatible with high water content. On PET-CT, most fillers show physiologic high FDG uptake, which should not be confounded with pathology. Abscess, cellulitis, non-inflammatory nodules, and foreign body granulomas are the most common filler-related complications, and imaging can help in the differential diagnosis. Diffusion weighted imaging helps in detecting a malignant lesion masked by injected facial fillers. Awareness of imaging features of facial fillers and their complications helps to avoid misinterpretation of MRI, and PET-CT scans and facilitates therapeutic decisions in unclear clinical cases. KEY POINTS: • Facial fillers are common incidental findings on MRI and PET-CT scans. • They have a characteristic appearance and typical anatomic distribution • Although considered as safe, facial filler injections are associated with several complications • As they may mask malignancy, knowledge of typical imaging features is mandatory. • MRI is a problem-solving tool for unclear cases.
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spelling pubmed-57072222017-12-05 Injectable facial fillers: imaging features, complications, and diagnostic pitfalls at MRI and PET CT Mundada, Pravin Kohler, Romain Boudabbous, Sana Toutous Trellu, Laurence Platon, Alexandra Becker, Minerva Insights Imaging Review ABSTRACT: Injectable fillers are widely used for facial rejuvenation, correction of disabling volumetric fat loss in HIV-associated facial lipoatrophy, Romberg disease, and post-traumatic facial disfiguring. The purpose of this article is to acquaint the reader with the anatomy of facial fat compartments, as well as with the properties and key imaging features of commonly used facial fillers, filler-related complications, interpretation pitfalls, and dermatologic conditions mimicking filler-related complications. The distribution of facial fillers is characteristic and depends on the anatomy of the superficial fat compartments. Silicone has signature MRI features, calcium hydroxyapatite has characteristic calcifications, whereas other injectable fillers have overlapping imaging features. Most fillers (hyaluronic acid, collagen, and polyalkylimide–polyacrylamide hydrogels) have signal intensity patterns compatible with high water content. On PET-CT, most fillers show physiologic high FDG uptake, which should not be confounded with pathology. Abscess, cellulitis, non-inflammatory nodules, and foreign body granulomas are the most common filler-related complications, and imaging can help in the differential diagnosis. Diffusion weighted imaging helps in detecting a malignant lesion masked by injected facial fillers. Awareness of imaging features of facial fillers and their complications helps to avoid misinterpretation of MRI, and PET-CT scans and facilitates therapeutic decisions in unclear clinical cases. KEY POINTS: • Facial fillers are common incidental findings on MRI and PET-CT scans. • They have a characteristic appearance and typical anatomic distribution • Although considered as safe, facial filler injections are associated with several complications • As they may mask malignancy, knowledge of typical imaging features is mandatory. • MRI is a problem-solving tool for unclear cases. Springer Berlin Heidelberg 2017-10-04 /pmc/articles/PMC5707222/ /pubmed/28980212 http://dx.doi.org/10.1007/s13244-017-0575-0 Text en © The Author(s) 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Review
Mundada, Pravin
Kohler, Romain
Boudabbous, Sana
Toutous Trellu, Laurence
Platon, Alexandra
Becker, Minerva
Injectable facial fillers: imaging features, complications, and diagnostic pitfalls at MRI and PET CT
title Injectable facial fillers: imaging features, complications, and diagnostic pitfalls at MRI and PET CT
title_full Injectable facial fillers: imaging features, complications, and diagnostic pitfalls at MRI and PET CT
title_fullStr Injectable facial fillers: imaging features, complications, and diagnostic pitfalls at MRI and PET CT
title_full_unstemmed Injectable facial fillers: imaging features, complications, and diagnostic pitfalls at MRI and PET CT
title_short Injectable facial fillers: imaging features, complications, and diagnostic pitfalls at MRI and PET CT
title_sort injectable facial fillers: imaging features, complications, and diagnostic pitfalls at mri and pet ct
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707222/
https://www.ncbi.nlm.nih.gov/pubmed/28980212
http://dx.doi.org/10.1007/s13244-017-0575-0
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