自体脂肪注射隆乳术后超声随访资料的回顾性分析  

Retrospective analysis of ultrasonic follow-up data after autologous fat injection augmentation mammoplasty

作　　者：付鹏[1] 李比[2] Fu Peng;Li Bi(Department of Ultrasound,Peking University Third Hospital,Beijing 100191,China;Department of Plastic Surgery,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院超声诊断科,北京100191 [2]北京大学第三医院成形外科,北京100191

出　　处：《中华整形外科杂志》2022年第6期630-634,共5页Chinese Journal of Plastic Surgery

摘　　要：目的总结乳房自体脂肪注射术后不同阶段的超声图像特点,探索超声作为术后影像学评价手段的价值。方法回顾性分析北京大学第三医院成形外科2015年10月至2021年9月进行乳房自体脂肪注射患者的超声影像学资料。根据图像观察手术后不同时间乳房各层次结构(皮肤层、皮下脂肪层、腺体层、乳房后间隙、胸壁肌肉层)是否清晰,有无异常回声,并记录异常回声所在位置、大小、形态、有无钙化及血流信号。结果共纳入61例患者,均为女性,年龄20~41岁。单次单侧乳房的脂肪注射量为70~300 ml,其中251~300 ml 15例,200~250 ml 36例,小于200 ml 10例。61例患者术后共进行了125次超声检查,每例患者进行了1~4次复查,复查距手术的时间间隔为1~47个月。连续观察术后患者的超声图像,变化主要体现在两方面:其一,乳房后间隙形成的脂肪带初期呈中等回声带,缺少条索状纹理,随着时间推移,其内逐渐形成较多且清晰的强回声间隔;其二,在乳房皮下脂肪层、腺体层及乳房后间隙均可见局灶性脂肪坏死,初期呈边界不清晰的不规则无回声区,随着时间推移其边缘回声渐增强,形成边界清楚的圆形或卵圆形无回声区。结论超声可作为乳房自体脂肪注射术后管理的一项有效且必要的手段,能为临床医生准确判断手术效果提供有价值的信息。Objective To analyze a series of ultrasonic follow-up data of breast at different stages after breast autologous fat injection,and explore the value of ultrasound as a means of postoperative imaging evaluation.Methods The clinical and ultrasonic data of patients who underwent breast autologous fat transplantation in the Department of Plastic Surgery of Peking University Third Hospital from October 2015 to September 2021 were analyzed retrospectively.According to the images,whether the breast structures at different levels(skin layer,subcutaneous fat layer,glandular layer,posterior breast space and chest wall muscle layer)were clear and whether there were abnormal echoes were observed.The location,size,shape,calcification and blood flow signals of abnormal echoes were recorded.Results A total of 61 female patients,aged 20-41 years,were included.The single fat injection volume of unilateral breast was 70-300 ml(including 251-300 ml,15 cases;200-250 ml,36 cases;less than 200 ml,10 cases).The ultrasonic images of postoperative patients were continuously obtained.The changes were mainly reflected in two aspects.One was the fat band formed in the posterior breast space,which showed a medium vocal cord in the initial stage and lacked a cord like texture.With the passage of time,more and clear strong echo intervals gradually formed in it.Second,focal fat necrosis can be identified in the subcutaneous fat layer,glandular layer and posterior breast space.At the initial stage,it is irregular and anechoic with unclear boundary.Over time,its edge echo increases,forming round or oval anechoic with clear boundary.Conclusions Ultrasound can be used as an effective and necessary means of postoperative management of breast autologous fat transplantation,and can provide valuable information for clinicians to accurately judge the surgical effect.

关 键 词：超声检查 超声检查 乳房 乳房整形 自体脂肪注射 

分 类 号：R655.8[医药卫生—外科学]