Breast augmentation is one of the most frequently performed cosmetic procedures worldwide, but it carries certain risks including breast implant rupture. Timely and accurate diagnostics of ruptures are crucial, as undiagnosed ruptures can lead to serious health complications. Imaging methods, such as magnetic resonance imaging (MRI), are recommended for the diagnosis of breast implants due to their high accuracy. However, current diagnostics rely heavily on the subjective interpretation and experience of the physician. This study investigates the potential of neural networks (NN) to address this limitation and improve the accuracy of rupture detection in silicone breast implants. We applied a deep learning-based neural network system trained on MRI images of breast implants to detect ruptures. The dataset included annotated MRI scans of symptomatic and asymptomatic patients with confirmed implant integrity or rupture. Several models were trained using ResNet-18, ResNet-50, and Xception networks, with various hyperparameter settings and augmentation techniques applied to enhance model performance and generalizability. The performance of the NN model was evaluated using confusion matrices and standard metrics such as true positive rate (TPR) and true negative rate (TNR). A semi-automated algorithm for the detection of intracapsular ruptures of breast implants on MRI was successfully developed. The algorithm correctly detected ruptures in 95.4% of cases and accurately identified cases without rupture in 86.7% of instances. Our findings highlight the potential of neural networks as a supportive tool in diagnosing breast implant ruptures. By semi-automating rupture detection, NNs can reduce diagnostic errors, expedite image evaluation, and optimize resource use in medical practice. The study underscores the importance of combining artificial intelligence with expert evaluation to enhance patient care and reduce costs in medical diagnostics.
In patients with large breasts undergoing a subcutaneous mastectomy with immediate implant-based reconstruction, is necessary to perform a mastopexy. The combination of these procedures increases the complication rate. To reduce it, it is necessary to cover the lower pole of the implant. Our study aimed to compare the use of an autologous dermal flap and an absorbable breast mesh. A total of 64 patients without previous breast surgery were divided into 2 groups, each with 32 patients. In the 1st group, the implant was covered with an autologous caudally based dermal flap, sutured to the great pectoral muscle. In the 2nd group, the implant was covered with a fully absorbable breast mesh, fixed caudally in the inframammary fold and cranially to the great pectoral muscle. The incidence of complications, the aesthetic effect, and patient satisfaction were evaluated in a one-year follow-up. In the 1st group, there were 2 cases of seroma, 2 partial nipple-areola complex necrosis, 4 cases of dehiscence in the T-suture, and the malposition of the implant in 2 patients. In the 2nd group, there were 2 cases of seroma, 2 cases of T-junction dehiscence, and 1 case of full nipple-areola complex necrosis, which resulted in implant loss. There was no significant difference in patient satisfaction between the study groups. The dermal flap is more suitable for breasts with pronounced ptosis. The use of the synthetic mesh is suitable for smaller breasts, where the possible dermal flap would be too small to cover the implant. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
- MeSH
- chirurgické síťky MeSH
- lidé MeSH
- mamoplastika * škodlivé účinky metody MeSH
- mastektomie metody MeSH
- nádory prsu * chirurgie MeSH
- nekróza chirurgie MeSH
- prsní bradavky chirurgie MeSH
- retrospektivní studie MeSH
- serom chirurgie MeSH
- subkutánní mastektomie * metody MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Cíl studie: Cílem práce je prezentace případu traumatické ruptury močového měchýře u pacientky s totálním prolapsem dělohy a stručný popis této problematiky. Typ studie: Kazuistika. Název a sídlo pracoviště: Gynekologicko-porodnická klinika 3. LF UK a Fakultní nemocnice Královské Vinohrady, Praha; Radiodiagnostická klinika 3. LF UK a Fakultní nemocnice Královské Vinohrady, Praha. Výsledky: Předkládáme kazuistiku pacientky s totálním prolapsem dělohy, která byla vyšetřena pro bolesti v podbřišku, hematurii a poruchu mikce. Obtíže vznikly náhle po pádu. Tyto symptomy jsou typické pro rupturu močového měchýře, je však třeba vyloučit i jiné častější příčiny. CT vyšetření prokázalo únik kontrastní látky z močového měchýře. Pacientka byla indikována k operační revizi a sutuře stěny močového měchýře. Závěr: Samostatně se ruptura močového měchýře vyskytuje zřídka. Nejčastěji je toto poranění součástí rozsáhlejších traumat; zejména po autonehodách. Nicméně naše kazuistika dokazuje, že je potřeba i tuto možnost zvažovat.
Objective: The aim of this work is to present a case of traumatic bladder rupture in a patient with total uterine prolapse. Additionally, we provide a brief description of this issue. Design: Case report. Setting: Department of Obstetrics and Gynaecology, 3rd Faculty of Medicine, Charles University and Královské Vinohrady University Hospital, Prague; Departement of Radiology, 3rd Faculty of Medicine, Charles University and Královské Vinohrady University Hospital, Prague. Results: We present a case report of a patient with a total uterine prolapse that has been examined for a lower abdominal pain, hematuria and difficulties with urination. The problems arose suddenly after the fall on the ground. These symptoms are typical for bladder rupture, but other more frequent causes have to be ruled out. CT scan showed a contrast agent leak from the bladder. The patient was indicated for surgical revision and suture of the bladder wall. Conclusion: Separately, rupture of the bladder occurs rarely. Most often, this injury is part of a wider trauma; especially after car crashes. However, our case report suggests that this option should be considered.
Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a rare peripheral T cell lymphoma. BIA-ALCL is a disease of the fibrous capsule surrounding the implant and occurs in patients after both breast reconstruction and augmentation. More than 300 cases have been reported so far, including two in a transgender patient. Here we describe BIA-ALCL presented with a mass in a transgender patient and the first case of BIA-ALCL in the Czech Republic. In 2007, a 33-year-old transgender male to female underwent bilateral breast augmentation as a part of his transformation to female. In June 2014, the patient developed a 5-cm tumorous mass in her left breast. Magnetic resonance imaging of the chest revealed a ruptured implant and a tumorous mass penetrating into the capsule and infiltrating the pectoral muscle. An R0 surgery was indicated-the implant, silicone gel and capsule were removed, and the tumorous mass was resected together with a part of the pectoral muscle. Histology revealed anaplastic large-cell lymphoma. The patient underwent standard staging procedures for lymphoma including a bone marrow trephine biopsy, which confirmed stage IE. The patient was treated with the standard chemotherapy for systemic ALCL-6 cycles of CHOP-21. The patient was tumor-free at the 2-year follow-up. BIA-ALCL has been reported mostly in women who received implants for either reconstructive or aesthetic augmentation. This is the third report of BIA-ALCL in a transgender person, the first in the Czech Republic. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
- MeSH
- anaplastický velkobuněčný lymfom diagnostické zobrazování etiologie terapie MeSH
- cyklofosfamid MeSH
- doxorubicin MeSH
- implantace prsní náhrady škodlivé účinky metody MeSH
- imunohistochemie MeSH
- jehlová biopsie MeSH
- kombinovaná terapie MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody MeSH
- nádory prsu diagnostické zobrazování etiologie terapie MeSH
- následné studie MeSH
- odstranění implantátu MeSH
- PET/CT MeSH
- prednison MeSH
- protokoly protinádorové kombinované chemoterapie MeSH
- prsní implantáty škodlivé účinky MeSH
- silikonové gely škodlivé účinky MeSH
- transgender osoby MeSH
- vinkristin MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Cíl. Prezentace prvních zkušeností s technikou vakuové biopsie na magnetické rezonanci (MR). Metoda. Všechna vyšetření byla provedena na přístroji Magnetom Avanto 1,5T (Siemens, Erlangen, Německo) s využitím systému Breast Biopsy System (Siemens, Erlangen, Německo). Vlastní biopsie byly prováděny bioptickým systémem Vacora Vacuum Assisted Breast Biopsy pracujícím na principu vakuové biopsie. Výsledky. V období od srpna 2007 do dubna 2008 bylo vyšetřeno 17 pacientek. Histologicky se jednalo o 6× invazivní karcinom (36 %), 2× DCIS (11 %), 6× benigní nález (36 %), 3× normální tkáň mamy (17 %). Žádné vyšetření nemuselo být zrušeno či předčasně ukončeno z důvodů technických či jiných, během vyšetření ani po vyšetření nebyla zaznamenána žádná zdravotní komplikace. Závěr. Biopsie pod MR kontrolou vhodně doplňuje celý vyšetřovací algoritmus při diagnostice karcinomu prsu. V kombinaci s magnetickou rezonancí se biopsie vyznačuje vysokou senzitivitou. Uplatnění nachází zejména v případech, kdy ložisková léze v prsu nemá korelát v jiných modalitách.
Aim. Presentation of our first experiences with vacuum biopsy technique guided by magnetic resonance (MR). Materials and method. All examinations were performed on MR Magnetom Avanto 1.5T system (Siemens, Erlangen, Germany) with Breast Biopsy device system (Siemens, Erlangen, Germany). The biopsies were done using Vacora Vacuum Assisted Breast Biopsy system. Results. 17 patients were examined from September 2007 till April 2008. Histological verification was 6× invasive carcinoma (36%), 2× DCIS (11%), 6× benign lesion (36%), 3× normal breast tissue (17%). No examination had to be cancelled or precociously ended from any reasons, there was no medical complication after the procedure. Conclusion. Biopsy guided under MR control precisely fills up the whole examination algorithm in diagnostics of breast carcinoma. Such biopsy in combination with MR displays high sensitivity. The use of this technique is especially valuable in cases, where breast lesion has no correlation in any other modality.
- MeSH
- biopsie metody přístrojové vybavení využití MeSH
- histologické techniky metody využití MeSH
- kontrastní látky MeSH
- lidé MeSH
- magnetická rezonance intervenční metody přístrojové vybavení využití MeSH
- meglumin analogy a deriváty diagnostické užití MeSH
- nádory prsu diagnóza MeSH
- nemoci prsů diagnóza MeSH
- prospektivní studie MeSH
- senzitivita a specificita MeSH
- výsledky a postupy - zhodnocení (zdravotní péče) metody trendy využití MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
