Rijkx Maud E P, Heuts Esther M, Houwers Janneke B, Hommes Juliette E, Piatkowski Andrzej A, van Nijnatten Thiemo J A
Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center+, 6202 AZ, Maastricht, The Netherlands.
NUTRIM School for Nutrition, and Translational Research in Metabolism, Maastricht University, 6229 ER, Maastricht, The Netherlands.
BJR Open. 2024 Apr 24;6(1):tzae010. doi: 10.1093/bjro/tzae010. eCollection 2024 Jan.
Autologous fat transfer (AFT) is an upcoming technique for total breast reconstruction. Consequently, radiological imaging of women with an AFT reconstructed breast will increase in the coming years, yet radiological experience and evidence after AFT is limited. The surgical procedure of AFT and follow-up with imaging modalities including mammography (MG), ultrasound (US), and MRI in patients with a total breast reconstruction with AFT are summarized to illustrate the radiological normal and suspicious findings for malignancy. Imaging after a total breast reconstruction with AFT appears to be based mostly on benign imaging findings with an overall low biopsy rate. As higher volumes are injected in this technique, the risk for the onset of fat necrosis increases. Imaging findings most often are related to fat necrosis after AFT. On MG, fat necrosis can mostly be seen as oil cysts. The occurrence of a breast seroma after total breast reconstruction with AFT is an unfavourable outcome and may require special treatment. Fat deposition in the pectoral muscle is a previously unknown, but benign entity. Although fat necrosis is a benign entity, it can mimic breast cancer (recurrence). In symptomatic women after total breast reconstruction with AFT, MG and US can be considered as first diagnostic modalities. Breast MRI can be used as a problem-solving tool during later stage. Future studies should investigate the most optimal follow-up strategy, including different imaging modalities, in patients treated with AFT for total breast reconstruction.
自体脂肪移植（AFT）是一种新兴的全乳重建技术。因此，未来几年接受AFT乳房重建的女性的放射影像学检查将会增加，但AFT后的放射学经验和证据有限。总结了AFT的手术过程以及对接受AFT全乳重建患者采用包括乳腺X线摄影（MG）、超声（US）和磁共振成像（MRI）等成像方式进行随访的情况，以说明恶性肿瘤的放射学正常和可疑表现。AFT全乳重建后的影像学表现似乎大多基于良性影像学表现，活检率总体较低。由于该技术注入的脂肪量较大，脂肪坏死发生的风险增加。影像学表现最常与AFT后的脂肪坏死有关。在MG上，脂肪坏死大多可表现为油囊肿。AFT全乳重建后出现乳腺血清肿是一种不良结果，可能需要特殊治疗。脂肪沉积于胸肌是一种此前未知的良性病变。虽然脂肪坏死是一种良性病变，但它可以模仿乳腺癌（复发）。对于接受AFT全乳重建后出现症状的女性，MG和US可被视为首选诊断方式。乳腺MRI可在后期用作解决问题的工具。未来的研究应调查接受AFT全乳重建患者的最佳随访策略，包括不同的成像方式。
