我们介绍了一例81岁的妇女,她因右侧乳房伤口出血而被送往急诊科。患者先前的影像学提示双侧硅胶植入物破裂,并且对MRI扫描的耐受性较低。紧急情况下的超声成像显示右乳的发现,提示有游离硅胶和血肿的瘘管。随后的光子计数CT扫描与定制的硅胶特定分割允许硅胶与血肿的区别,提供了瘘管的解剖评估和位置,并显示双侧硅胶诱导的淋巴结肿大。
We present a case of an 81-year-old woman who presented to the emergency department with bleeding from a right breast wound. The patient had prior imaging suggestive of bilateral silicone implant rupture and a history of low tolerance for MRI scans. Ultrasound imaging in the emergency setting showed findings in the right breast suggestive of a fistula with free silicone and hematoma. A subsequent photon-counting CT scan with custom silicone-specific segmentation allowed differentiation of silicone from hematoma, provided anatomic assessment and location of the fistula, and revealed bilateral silicone-induced lymphadenopathy.