Nanda Deepa Thimmappa1,2, Martin R Prince1,2, Kari L Colen1,2, Christina Y Ahn1,2, Silvina P Dutruel1,2, Srikanth R Boddu1,2, David T Greenspun1,2, Julie V Vasile1,2, Constance M Chen1,2, Hakan Usal1,2, Christine H Rohde1,2, Jeremiah S Redstone1,2, Maria M LoTempio1,2, Oren Z Lerman1,2, Anik K Nath1,2, Robert J Allen1,2, Joshua L Levine1,2. 1. New York and Mt. Kisco, N.Y.; Hakensack and Paramus, N.J.; and Greenwich, Conn. 2. From the Department of Radiology, Weill Cornell Medical College; New York-Presbyterian Hospital, Columbia University; the Department of Plastic Surgery, New York University Langone Medical Center; the Department of Radiology and Imaging Sciences, New York Presbyterian Hospital; the Department of Plastic Surgery, Albert Einstein Medical Center; the Division of Plastic and Reconstructive Surgery, Northern Westchester Hospital; Division of Plastic and Reconstructive Surgery, New York Presbyterian Lower Manhattan Hospital; the Department of Plastic Surgery, Lenox Hill Hospital; the Department of Plastic Surgery, North Shore Long Island Jewish Medical Center; LoTempio Plastic Surgery for Women; State University of New York-Downstate College of Medicine; Department of Plastic Surgery, New York Eye and Ear Infirmary of Mount Sinai; ColenMD Plastic Surgery and Usal Plastic Surgery Center; and the Department of Plastic Surgery, Greenwich Hospital.
Abstract
BACKGROUND: The purpose of this study was to evaluate breast tissue expanders with magnetic ports for safety in patients undergoing abdominal/pelvic magnetic resonance angiography before autologous breast reconstruction. METHODS: Magnetic resonance angiography of the abdomen and pelvis at 1.5 T was performed in 71 patients in prone position with tissue expanders with magnetic ports labeled "MR Unsafe" from July of 2012 to May of 2014. Patients were monitored during magnetic resonance angiography for tissue expander-related symptoms, and the chest wall tissue adjacent to the tissue expander was examined for injury at the time of tissue expander removal for breast reconstruction. Retrospective review of these patients' clinical records was performed. T2-weighted fast spin echo, steady-state free precession and gadolinium-enhanced spoiled gradient echo sequences were assessed for image artifacts. RESULTS: No patient had tissue expander or magnetic port migration during the magnetic resonance examination and none reported pain during scanning. On tissue expander removal (71 patients, 112 implants), the surgeons reported no evidence of tissue damage, and there were no operative complications at those sites of breast reconstruction. CONCLUSION: Magnetic resonance angiography of the abdomen and pelvis in patients with certain breast tissue expanders containing magnetic ports can be performed safely at 1.5 T for pre-autologous flap breast reconstruction perforator vessel mapping. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
BACKGROUND: The purpose of this study was to evaluate breast tissue expanders with magnetic ports for safety in patients undergoing abdominal/pelvic magnetic resonance angiography before autologous breast reconstruction. METHODS: Magnetic resonance angiography of the abdomen and pelvis at 1.5 T was performed in 71 patients in prone position with tissue expanders with magnetic ports labeled "MR Unsafe" from July of 2012 to May of 2014. Patients were monitored during magnetic resonance angiography for tissue expander-related symptoms, and the chest wall tissue adjacent to the tissue expander was examined for injury at the time of tissue expander removal for breast reconstruction. Retrospective review of these patients' clinical records was performed. T2-weighted fast spin echo, steady-state free precession and gadolinium-enhanced spoiled gradient echo sequences were assessed for image artifacts. RESULTS: No patient had tissue expander or magnetic port migration during the magnetic resonance examination and none reported pain during scanning. On tissue expander removal (71 patients, 112 implants), the surgeons reported no evidence of tissue damage, and there were no operative complications at those sites of breast reconstruction. CONCLUSION: Magnetic resonance angiography of the abdomen and pelvis in patients with certain breast tissue expanders containing magnetic ports can be performed safely at 1.5 T for pre-autologous flap breast reconstruction perforator vessel mapping. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
Authors: Joshua H Choo; Mitchell J Buller; Michelle O'Brien; Ron Hazani; Adam Augenstein; John P Tutela; Bradon J Wilhelmi Journal: Eplasty Date: 2019-04-17