Pierrefeu-Lagrange A C, Delay E, Guerin N, Chekaroua K, Delaporte T
Service de chirurgie plastique, esthétique et réparatrice, CHU Bellevue, Saint-Etienne, France.
Ann Chir Plast Esthet. 2006 Feb;51(1):18-28. doi: 10.1016/j.anplas.2005.10.001. Epub 2005 Dec 9.
We have been using the lipomodeling technique since 1999 in order to improve the form and the volume of the breasts reconstructed with latissimus dorsi flap. During several recent years this technique has known a considerable development and its results are quite attractive. At the same time, the breast imaging remains to be a fundamental mean of cancer control. The knowledge of radiological manifestations of the implanted fat tissue is very important. The aim of this study was to evaluate the imaging aspects of lipomodeling in breasts reconstructed with latissimus dorsi flap, using three types of explorations: ultrasound, radiological mammography and MRI. A total of 30 patients were included into the study with average age of 51 years. All of these patients underwent a breast reconstruction using a latissimus dorsi flap with lipomodeling, which average volume reached 165 cc. Four of the patient had a bilateral breast reconstruction. Three modes of imaging (ultrasound, mammography and MRI) were performed a year after the surgery. In 20 patients the imaging findings proved to be normal (in total 34 breasts). An image of fat tissue was revealed in 14 cases and some benign microcalcifications were found in 4 patients. A suspicious tissular image was discovered in one patient, who later underwent a biopsy. The result was a benign giant cell granuloma. In conclusion, the lipomodeling technique does not affect the postoperative follow-up of the patients with breast cancer and an imaging controlled biopsy is possible in case of any doubt. At present, some additional studies are underway evaluating the fat tissue transplants in normal breasts, in order to widen its indications in the plastic breast surgery.
自1999年以来,我们一直在使用脂肪建模技术来改善背阔肌肌皮瓣重建乳房的形态和体积。近年来,这项技术有了长足的发展,其效果相当诱人。与此同时,乳房成像仍然是癌症控制的一项基本手段。了解植入脂肪组织的放射学表现非常重要。本研究的目的是通过超声、乳腺钼靶摄影和磁共振成像三种检查方法,评估背阔肌肌皮瓣重建乳房中脂肪建模的成像情况。共有30例患者纳入研究,平均年龄51岁。所有这些患者均接受了背阔肌肌皮瓣联合脂肪建模的乳房重建,平均体积达165立方厘米。其中4例患者进行了双侧乳房重建。术后一年进行了三种成像检查(超声、乳腺钼靶摄影和磁共振成像)。20例患者的成像结果显示正常(共34个乳房)。14例发现脂肪组织影像,4例患者发现一些良性微钙化。1例患者发现可疑组织影像,随后进行了活检,结果为良性巨细胞肉芽肿。总之,脂肪建模技术不影响乳腺癌患者的术后随访,如有任何疑问可行成像引导下活检。目前,一些额外的研究正在进行,以评估正常乳房中的脂肪组织移植,从而扩大其在乳房整形手术中的应用指征。