Herold C, Ueberreiter K, Cromme F, Grimme M, Vogt P M
Medizinische Hochschule Hannover, Klinik für Plastische-, Hand- und Wiederherstellungschirurgie, Zentrum für Schwerbrandverletzte, Hannover.
Handchir Mikrochir Plast Chir. 2011 Apr;43(2):119-24. doi: 10.1055/s-0030-1269931. Epub 2011 Feb 1.
Autologous fat transplantation to the female breast is becoming generally accepted as a standard procedure in plastic surgery. Periglandular planes and also intrapectoral planes are used, based on the idea of having a highly vascularised matrix. To assess this surgical technique a reproducible and exact tool for volume analysis is necessary.
The volume of pectoral muscles and breast tissue including periglandular fat was analysed by MRI volumetry before and 6 months after autologous fat transplantation in 10 patients. The volume of the glandular tissue itself was also analysed to evaluate the effect of volume up-, and down-turns between the 6 months.
A comparison of the volumes calculated with MRI volumetry preoperatively and postoperatively revealed a mean volume persistence of 64% (± 13%) within the pectoral muscle and of 81% (± 8%) within the periglandular fat. Glandular volume had a mean alternation of 7% (± 4%). In relation to the region of interest for breast volumetry the glandular tissue represented 15% (± 5%) preoperatively und 13% (± 4%) postoperatively.
In autologous fat transplantation to the breast the periglandular plane is superior to the intramuscular plane in terms of volume persistence. As bolus injections of fat tissue must be strictly avoided, the pectoral muscles offer an additional receptor tissue for fat transplantation, and might be especially needed in smaller breasts to achieve the desired volume augmentation. The alternation of glandular tissue within the 2 points of time was low and in relation to the whole region of interest for breast volumetry rather inconsequential. Nevertheless consideration and subtraction of the glandular volume in mamma volumetry optimises the exactness of the volumetry.
自体脂肪移植至女性乳房正逐渐成为整形外科普遍认可的标准手术。基于拥有高度血管化基质的理念，采用腺周平面以及胸内平面。为评估该手术技术，需要一种可重复且精确的体积分析工具。
对10例患者在自体脂肪移植术前及术后6个月通过MRI容积测定法分析胸肌以及包括腺周脂肪在内的乳腺组织的体积。还分析了腺体组织本身的体积，以评估这6个月间体积增加和减少的效果。
术前和术后通过MRI容积测定法计算的体积比较显示，胸肌内平均体积留存率为64%（±13%），腺周脂肪内为81%（±8%）。腺体体积平均变化为7%（±4%）。就乳房容积测定的感兴趣区域而言，腺体组织术前占15%（±5%），术后占13%（±4%）。
在自体脂肪移植至乳房中，就体积留存而言，腺周平面优于肌内平面。由于必须严格避免脂肪组织的团注注射，胸肌为脂肪移植提供了额外的受体组织，对于较小乳房可能尤其需要，以实现期望的体积增大。两个时间点之间腺体组织的变化较小，相对于乳房容积测定的整个感兴趣区域而言影响不大。然而，在乳房容积测定中考虑并减去腺体体积可优化容积测定的准确性。
