Fujii Takaaki, Yamaguchi Satoru, Yajima Reina, Tsutsumi Soichi, Asao Takayuki, Kuwano Hiroyuki
Department of General Surgical Science, Gunma University, Gunma, Japan.
Am Surg. 2012 Sep;78(9):933-5.
Preoperative assessment of breast volume could contribute significantly to the planning of breast reconstructive surgery. However, breast volume measurements are not carried out on a routine basis, because there is still no commonly accepted standard method for such measurements. In the current study, we assessed whether routine computed tomography (CT) of the chest using a three-dimensional device could provide accurate estimation of breast volumes in patients with breast cancer. Ten consecutive patients and 11 breasts with breast cancer that underwent mastectomy with immediate breast reconstruction were enrolled in this study. In each case, a three-dimensional image was constructed according to the CT data using a volume-rendering technique. Computed breast volumes were compared with known breast volumes obtained from surgical specimens. The mean breast volume of surgical specimens was 324.1 ± 173.5 mL. The mean breast volume value was established to be 351.6 ± 174.3 mL with three-dimensional CT in a novel method. There was a strong linear association between breast volumes of surgical specimens and breast volumes measured by the three-dimensional CT method when using a Pearson correlation (r = 0.985, P < 0.001). Our results suggest that the calculation of breast volume using three-dimensional CT is accurate enough to have a significant clinical benefit in planning reconstructive breast surgery. This method can help the surgeon predict the esthetic effect of various breast surgeries and guide the choice of the most appropriate implant preoperatively.
术前评估乳房体积对乳房重建手术的规划具有重要意义。然而,乳房体积测量并非常规进行,因为目前尚无普遍接受的标准测量方法。在本研究中,我们评估了使用三维设备进行胸部常规计算机断层扫描(CT)是否能准确估计乳腺癌患者的乳房体积。本研究纳入了10例连续的乳腺癌患者及11侧乳房,这些患者均接受了乳房切除并即刻进行乳房重建。在每例患者中,利用容积再现技术根据CT数据构建三维图像。将计算得出的乳房体积与手术标本的已知乳房体积进行比较。手术标本的平均乳房体积为324.1±173.5 mL。采用一种新方法通过三维CT得出的平均乳房体积值为351.6±174.3 mL。使用Pearson相关性分析时,手术标本的乳房体积与三维CT测量的乳房体积之间存在强线性关联(r = 0.985,P < 0.001)。我们的结果表明,使用三维CT计算乳房体积足够准确,对乳房重建手术规划具有显著临床益处。该方法可帮助外科医生预测各种乳房手术的美学效果,并在术前指导选择最合适的植入物。