乳腺MRI在乳腺癌保留乳头乳晕复合体Ⅰ期乳房重建中的应用  

Application of breast MRI in stageⅠbreast reconstruction with nipple-areola complex-preserving in breast cancer

作　　者：孙宇[1] 黎冠宏[1] 王存富 董菊红[1] 钱朋飞[1] 闻国权[1] 邓素华[1] SUN Yu;LI Guanhong;WANG Cunfu;DONG Juhong;QIAN Pengfei;WEN Guoquan;DENG Suhua(Department of Breast Center,The Third People’s Hospital of Huizhou,Huizhou 516002,Guangdong Province,China)

机构地区：[1]惠州市第三人民医院乳腺中心,广东惠州516002

出　　处：《肿瘤影像学》2023年第3期256-261,共6页Oncoradiology

摘　　要：目的:探究乳腺磁共振成像(magnetic resonance imaging,MRI)在乳腺癌保留乳头乳晕复合体(nipple-areola complex,NAC)Ⅰ期乳房重建中的应用价值。方法:选取惠州市第三人民医院75例乳腺癌患者,均行保留NACⅠ期乳房重建。术前采用乳腺MRI评估乳房内肿瘤边缘与皮肤的距离、肿瘤边缘与NAC的距离,依据术前MRI测量数据评估皮下腺体切除的范围,计算计划切除组织体积,指导假体大小选择。并于术中测量乳房肿瘤边缘与皮肤的距离、肿瘤边缘与NAC的距离,测量术中实际切除组织体积、植入假体体积,比较MRI与术中测量数据,采用Pearson相关系数分析两组数据的线性关系,统计术后并发症发生情况、乳房重建美容效果。结果:乳腺MRI测量乳房内肿瘤边缘与皮肤的距离与术中测量比较,差异无统计学意义(P>0.05),两者呈正相关(r=0.747,P<0.05);乳腺MRI测量肿瘤边缘与NAC的距离与术中测量比较,差异无统计学意义(P>0.05),两者呈正相关(r=0.752,P<0.05);乳腺MRI测量计划切除组织体积与实际切除组织体积、植入假体体积比较,差异无统计学意义(P>0.05),计划切除组织体积与实际切除组织体积、植入假体体积呈正相关(r=0.762、0.776,P<0.05);术后并发症总发生率为6.67%,主观美容效果优良率为86.67%,客观美容效果优良率为82.67%。结论:保留NACⅠ期乳房重建术前行乳腺MRI测量乳腺癌患者肿瘤位置、乳房内肿瘤边缘与皮肤的距离、肿瘤边缘与NAC的距离,可指导皮下腺体组织切除及假体大小选择,有利于术中安全保留部分乳房内部分脂肪组织,从而获得良好的乳房重建美容效果,减少术后并发症。Objective:To explore the application value of breast magnetic resonance imaging(MRI)in breast reconstruction with nipple-areola complex(NAC)-preserving stageⅠbreast reconstruction.Methods:A total of 75 breast cancer patients in Huizhou Third People’s Hospital were selected and all underwent NAC-preserving stageⅠbreast reconstruction.Before surgery,breast MRI was used to evaluate the thickness of fat in the breast,the thickness of the glands,and the distance from the tumor edge to the NAC.According to the preoperative MRI measurement data,the tumor resection range was determined,the planned tissue volume was calculated,and the size of the prosthesis was guided.During the operation,the thickness of the breast fat,the thickness of the glands,and the distance from the tumor edge to the NAC were measured,the volume of the tissues removed and the volume of the prosthesis was measured during operation,and the MRI and intraoperative measurement data were compared.The Pearson correlation coefficient model was used to analyze the two groups the linear relationship of the data,the statistics of postoperative complications,and the beauty effect of breast reconstruction.Results:There was no statistically significant difference between the distance of the tumor margin from the skin in the breast measured by breast MRI and intraoperative measurement(P>0.05),and the two were positively correlated(r=0.747,P<0.05).Breast MRI measured gland thickness was compared with intraoperative measurement,and the difference was not statistically significant(P>0.05),and the two were positively correlated(r=0.744,P<0.05).The distance between the tumor edge and the NAC measured by breast MRI was not statistically significant(P>0.05),the two were positively correlated(r=0.752,P<0.05).There was no statistically significant difference between the planned resected tissue volume measured by breast MRI and the actual resected tissue volume and the implanted prosthesis volume(P>0.05).The planned resected tissue volume was positively correlated wi

关 键 词：乳腺癌 磁共振成像 乳头乳晕复合体 乳房重建 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]