Kwong Jeffrey W, Tijerina Jonathan David, Choi Sara, Luan Anna, Feng Carol L, Nguyen Dung H, Lee Gordon K, Nazerali Rahim S
From the Stanford University School of Medicine, Stanford, CA.
Division of Plastic & Reconstructive Surgery, Stanford University, Stanford, CA.
Ann Plast Surg. 2020 May;84(5S Suppl 4):S311-S317. doi: 10.1097/SAP.0000000000002244.
Preoperative prediction of breast volume can guide patient expectations and aid surgical planning in breast reconstruction. Here, we evaluate the accuracy of a portable surface imager (Crisalix S.A., Lausanne, Switzerland) in predicting breast volume compared with anthropomorphic estimates and intraoperative specimen weights.
Twenty-five patients (41 breasts) undergoing mastectomy were scanned preoperatively with the Crisalix surface imager, and 1 of 3 attending plastic surgeons provided an anthropomorphic volume estimate. Intraoperative mastectomy weights were used as the gold standard. Volume conversions were performed assuming a density of 0.958 g/cm.
The Pearson correlation coefficient between imager estimates and intraoperative volumes was 0.812. The corresponding value for anthropomorphic estimates and intraoperative volumes was 0.848. The mean difference between imager and intraoperative volumes was -233.5 cm, whereas the mean difference between anthropomorphic estimates and intraoperative volumes was -102.7 cm. Stratifying by breast volume, both surface imager and anthropomorphic estimates closely matched intraoperative volumes for breast volumes 600 cm and less, but the 2 techniques tended to underestimate true volumes for breasts larger than 600 cm. Stratification by plastic surgeon providing the estimate and breast surgeon performing the mastectomy did not eliminate this underestimation at larger breast volumes.
For breast volumes 600 cm and less, the accuracy of the Crisalix surface imager closely matches anthropomorphic estimates given by experienced plastic surgeons and true volumes as measured from intraoperative specimen weights. Surface imaging may potentially be useful as an adjunct in surgical planning and guiding patient expectations for patients with smaller breast sizes.
术前预测乳房体积可指导患者预期，并有助于乳房重建的手术规划。在此，我们评估一种便携式表面成像仪（瑞士洛桑的Crisalix S.A.公司）与人体测量估计值及术中标本重量相比，在预测乳房体积方面的准确性。
对25例接受乳房切除术的患者（41个乳房）进行术前Crisalix表面成像仪扫描，3名主治整形外科医生中的1名提供人体测量体积估计值。术中乳房切除重量用作金标准。假设密度为0.958 g/cm³进行体积换算。
成像仪估计值与术中体积之间的Pearson相关系数为0.812。人体测量估计值与术中体积的相应值为0.848。成像仪与术中体积的平均差值为-233.5 cm³，而人体测量估计值与术中体积的平均差值为-102.7 cm³。按乳房体积分层，对于体积600 cm³及以下的乳房，表面成像仪和人体测量估计值均与术中体积密切匹配，但对于大于600 cm³的乳房，这两种技术往往低估真实体积。按提供估计值的整形外科医生和进行乳房切除术的乳腺外科医生分层，在较大乳房体积时并不能消除这种低估。
对于体积600 cm³及以下的乳房，Crisalix表面成像仪的准确性与经验丰富的整形外科医生给出的人体测量估计值以及术中标本重量测量的真实体积密切匹配。表面成像可能作为手术规划的辅助手段，并有助于指导较小乳房尺寸患者的预期。
