Department of Plastic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1#, Dongcheng District, Beijing, 100730, People's Republic of China.
Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1#, Dongcheng District, Beijing, 100730, People's Republic of China.
Aesthetic Plast Surg. 2023 Oct;47(5):1759-1770. doi: 10.1007/s00266-023-03506-9. Epub 2023 Jul 27.
Data on the value of magnetic resonance imaging (MRI) in the preoperative evaluation and surgery planning of gynecomastia are limited. The purpose of this study is to reveal MRI features and categories of gynecomastia and compare surgical outcomes following MRI and sonography as well as their diagnostic accuracy.
The area of the gland and the whole breast on the transverse plane via nipple of MRI were measured to calculate the ratio between them. Areola, mass and branch patterns were categorized to represent three different gynecomastia type on MRI. 183 patients were included, with 38 in MRI group and 145 in sonography group. Diagnostic accuracy was assessed by the level of agreement between preoperative imaging findings and intraoperative observations. Surgical data, patients' satisfaction and complications were compared between the two groups.
MRI in 75 gynecomastic breasts demonstrated the average ratio of the gland to the whole breast was 10.6%±13.3%. The most common MRI categories were branch patterns (45.3%). The diagnostic concordance rate of MRI was higher than sonography (100% vs. 86.8%, p = 0.001). Among those junior surgeons, the length of surgery was reduced in MRI group (100 min vs. 115 min, p = 0.048). There was no difference in terms of patient's satisfaction and complication rate between MRI and sonography.
MRI was superior to sonography in diagnostic accuracy to assess the tissue components of gynecomastia and provided informative guidance especially for junior surgeons. Surgical outcomes were comparable regardless of the use of MRI or sonography for evaluation.
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磁共振成像（MRI）在男性乳房发育症的术前评估和手术规划中的应用价值的数据有限。本研究旨在揭示男性乳房发育症的 MRI 特征和类型，并比较 MRI 和超声检查的手术结果及其诊断准确性。
通过乳头在横断面上测量 MRI 中腺体和整个乳房的面积，以计算它们之间的比值。乳晕、肿块和分支模式被分类，以代表 MRI 上的三种不同的男性乳房发育症类型。共纳入 183 例患者，其中 MRI 组 38 例，超声组 145 例。通过术前影像学检查结果与术中观察结果的一致性评估诊断准确性。比较两组的手术数据、患者满意度和并发症。
75 例男性乳房发育症的 MRI 显示腺体与整个乳房的平均比值为 10.6%±13.3%。最常见的 MRI 分类为分支模式（45.3%）。MRI 的诊断一致性率高于超声（100% vs. 86.8%，p=0.001）。在那些初级外科医生中，MRI 组的手术时间缩短（100 分钟 vs. 115 分钟，p=0.048）。MRI 和超声检查在患者满意度和并发症发生率方面无差异。
MRI 在评估男性乳房发育症的组织成分方面优于超声，特别是为初级外科医生提供了有价值的指导。无论使用 MRI 还是超声进行评估，手术结果都是可比的。
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