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C Y Ahn

Publications and source records attributed to C Y Ahn.

25 records · Page 2Linked to original sources

Definitive diagnosis of breast implant rupture using magnetic resonance imaging.

Breast implant rupture is an important complication of augmented and reconstructed breasts. Although several techniques such as mammography, xeromammography, ultrasound, thermography, and computed tomographic (CT) scanning have been proven to be useful to detect implant rupture, they have several disadvantages and lack specificity. In the current study, we have established magnetic resonance imaging (MRI) as a definitive, reliable, and reproducible technique to diagnose both intracapsular and extracapsular ruptures. The study was conducted in 100 symptomatic patients. Our imaging parameters were able to identify ruptures in implants with silicone shells. All the ruptures showed the presence of wavy lines, free-floating silicone shell within the gel ("free-floating loose-thread sign" or "linguine sign"). We had a 3.75 percent incidence of false-positive and false-negative results. The sensitivity for detection of silicone implant rupture was 76 percent, with a specificity of 97 percent. In addition, we also were able to identify the artifacts that may interfere with the definitive diagnosis of implant rupture.

Adult↗

Silicone breast implants: US evaluation.

PURPOSE: To determine the value of breast ultrasonography (US) in the assessment of silicone breast implants for rupture. MATERIALS AND METHODS: Seventy-four women with local or systemic symptoms related to silicone implants underwent breast US. Of these, 28 underwent surgical removal of the implants. RESULTS: Of 57 implants removed, 37 were intact. The most reliable sign of an intact implant was an anechoic interior, although reverberation artifact and radical folds could be seen. Of 20 ruptured implants, 16 were intracapsular and four were extracapsular ruptures. The most reliable US sign of rupture was echogenic, horizontal ("stepladder") lines (14 of 20 ruptures). Two of the four extracapsular ruptures were accurately identified as echogenic nodules outside the implant; two were false-negative findings. Three intracapsular ruptures identified at US were false-positive; six were false-negative. Overall sensitivity for rupture was 70%, specificity was 92%, positive predictive value was 82%, and negative predictive value was 85%. CONCLUSION: Breast US is capable of depicting intracapsular and extracapsular rupture of breast implants.

Adult↗

MR imaging of the breast in patients with silicone-gel implants: spectrum of findings.

Because of recent concerns about the potential dangers of rupture and leakage of silicone-gel implants, radiologists are often requested to evaluate the integrity of normal breast implants. Clinical studies suggest that MR imaging can accurately depict implant rupture. The purpose of this pictorial essay is to illustrate the spectrum of MR appearances of breasts in patients with silicone-gel implants. Types of prostheses range from the more common single-lumen silicone-gel implants to the rare foam-filled implants. Recognition of the variable appearance of intact implants is emphasized in order to distinguish these from intracapsular or extracapsular ruptures. Finally, we briefly review various investigational MR sequences designed to improve the evaluation of the integrity of silicone-gel implants and the localization of free silicone. This article is based on our experience in performing MR imaging in more than 350 patients with breast implants. In more than 50% of these patients, the MR imaging findings have been correlated with surgical and pathologic findings.

Adult↗

Silicone breast implants in vivo: MR imaging.

This study was designed to evaluate pulse sequences and patient positioning for MR imaging of silicone breast implants in patients. One hundred forty-three patients (281 silicone implants) underwent imaging over a 21-month period. The combination of a T2-weighted fast spin echo technique (SE), T2-weighted fast SE with water suppression, and T1-weighted SE with fat suppression is recommended to reliably differentiate silicone from other breast tissues and to identify intracapsular and extracapsular ruptures or leaks. Seventy of the 143 patients underwent removal of their silicone implants. The sensitivity for detection of silicone implant rupture was 76%, with a specificity of 97%. Positioning the patient prone improved image quality.

Adult↗

Microvascular free flaps in breast reconstruction.

There is no longer any doubt that free flaps can achieve the best breast reconstruction. Proof is the rapidly increasing popularity of the method. Its many advantages, the indications for each flap, and the technical refinements are presented.

Female↗

Superior aspect of the perirenal space: anatomy and pathological correlation.

To study the anatomy of the superior aspect of the perirenal space, we analysed 50 computed tomographic (CT) scans with reference to the anatomy of Gerota's fascia, and dissected five cadavers laying special emphasis on the ascent of Gerota's fascia. We also reviewed 10 scans of patients with a large lesion in the right upper abdomen regarding localisation of the lesion. We conclude that Gerota's fascia does not cover the upper portion of the kidney and adrenal gland so that the superior aspect of the perirenal space is open towards the upper abdominal extraperitoneal space. Thus, a large lesion arising from the right adrenal gland or kidney easily invaginates the liver through the bare area mimicking a hepatic lesion, and vice versa. This explains the difficulty in localising a large lesion in the right upper abdomen.

Humans↗

Residual silicone detection using MRI following previous breast implant removal: case reports.

The current controversy surrounding the safety of silicone gel breast implants has resulted in an increasing number being removed. Although previous reports have suggested that remnants of the implant capsule are reabsorbed after explantation surgery, the persistence of the capsule in fact may be associated with implant fragments and silicone gel leakage. In this study we have used magnetic resonance imaging (MRI) to identify residual silicone gel and silicone granulomas following the removal of silicone gel breast implants. Four representative clinical case reports are presented. These patients, who had residual silicone present in their bodies, presented to us with breast pain, palpable masses, or abnormal calcific mass densities apparent on a mammogram. High-resolution MRI images were found to be helpful in identifying local and remote collections of silicone gel, silicone granulomas, and residual capsules that were incompletely removed from previous explantation surgery. MRI breast images demonstrated high resolution and provided the accurate anatomical locations of residual silicone gel and silicone granulomas in all the regions of breast parenchyma, chest wall muscles, and axillae. Patients with persistent local symptoms following explantation surgery may benefit from an evaluation of the breast using MRI.

Adult↗