MRIで静脈奇形が疑われた眼瞼眼窩内注入フィラー材の1例

An Intraorbital Foreign Body Considered a Vascular Malformation on MRI

はじめに

　近年，手術を伴わない（一般的にプチ整形といわれている）美容医療が増加傾向にある。以前は手術的に行っていた隆鼻や隆顎なども，多種のフィラー材の開発により，患部への製剤の注入による施術が多くなってきた。患者も医療者も，その侵襲性の低さと手技の簡便さから安易にこれを行う傾向にあるが，さまざまな合併症が報告されていることを熟知していなければならない 1）。今回われわれは，MRIでは眼瞼眼窩内の静脈奇形が疑われたものの，実際は過去に注入したフィラー材の残存であった症例を経験したので報告する。

　The use of nonsurgical cosmetic treatments has been on the rise. Numerous filler agents are available, and all cosmetic fillers may induce adverse reactions. We provide the details of a patient in whom a foreign body was detected in the orbit 8 years after the patient had undergone a rhinoplasty using a non-absorbable filler material. The MRI performed at the patientʼs first examination showed a low signal on T1-weighted images and a relatively high signal on T2-weighted images, which led us to suspect a venous malformation. However, when the incision was made, a gelatinous substance was observed, and the pathological findings suggested that it was the filler material that had been injected previously as part of the patientʼs rhinoplasty. There had been no preoperative declaration of a cosmetic medical history from the patient, but we believe that conducting an MRI examination would have suggested a history of injections if there had been a prior declaration.

　When MRI shows a vascular malformation in the orbit, the patient should be reexamined to determine the history of previous injections.