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MR imaging of the reconstructed breast: What the radiologist needs to know.

Dialani V, Lai KC, Slanetz PJ - Insights Imaging (2012)

Bottom Line: Surgical management of breast cancer often entails lumpectomy or mastectomy.In this article, we will review the more commonly encountered types of breast reconstruction, which include implants, tranversus rectus abdomnis flap, latissimus dorsi flap, deep inferior epigastric perforator flap, and gluteal flaps.Radiologists will better understand the different types of breast reconstruction after mastectomy and their normal imaging appearance on MRI.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Beth Israel Deaconess Medical Center, C/o Dr. Vandana Dialani, 330 Brookline Avenue, Boston, MA, 02215, USA, vdialani@bidmc.harvard.edu.

ABSTRACT

Objective: The objective is to review the different types of breast reconstruction following cancer surgery and describe expected imaging appearances and complications seen in the reconstructed breast.

Methods: Surgical management of breast cancer often entails lumpectomy or mastectomy. When mastectomy is performed, patients often opt for breast reconstruction. Most facilities do not routinely image the reconstructed breast with mammography.

Results: However, many of these women are imaged with screening breast MRI for evaluation of the contralateral breast, or they may develop a clinical problem that warrants a diagnostic evaluation with MRI. In this article, we will review the more commonly encountered types of breast reconstruction, which include implants, tranversus rectus abdomnis flap, latissimus dorsi flap, deep inferior epigastric perforator flap, and gluteal flaps. Each of these types of reconstruction has different appearances on MR. We will also discuss potential complications that can be seen in the reconstructed breasts, including fat necrosis and recurrence.

Conclusion: Radiologists will better understand the different types of breast reconstruction after mastectomy and their normal imaging appearance on MRI. Radiologists will be more aware of how to recognize complications related to surgery as well as how to determine whether recurrence is present.

Main messages: • The different surgical techniques used in breast reconstruction are discussed. • Describes the normal magnetic resonance imaging appearance of the breast after reconstruction. • Identify MR imaging features of benign sequelae and recurrence following breast reconstruction.

No MeSH data available.


Related in: MedlinePlus

a The DIEP flap is supplied by intramuscular perforators from the deep inferior epigastric artery and vein. b Axial fat-saturated T1W images with post-contrast gadolinium injection. c 3D reformatted axial image show replacement of the normal glandular tissue of the breast with lower abdominal fat and the anastomosis of the vascular pedicle (arrow) by microsurgical technique to the internal mammary artery. For comparison, note the normal glandular tissue in the left breast
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Fig4: a The DIEP flap is supplied by intramuscular perforators from the deep inferior epigastric artery and vein. b Axial fat-saturated T1W images with post-contrast gadolinium injection. c 3D reformatted axial image show replacement of the normal glandular tissue of the breast with lower abdominal fat and the anastomosis of the vascular pedicle (arrow) by microsurgical technique to the internal mammary artery. For comparison, note the normal glandular tissue in the left breast

Mentions: Perforator flaps allow the transfer of the patient’s own skin and fat in a reliable manner with minimal donor-site morbidity. During flap harvest, these perforators are meticulously dissected free from the surrounding muscle, which is spread in the direction of the muscle fibers and preserved intact. The pedicle is anastomosed to recipient vessels in the chest, and the donor site is closed without the use of mesh or other materials [6–8] (Figs. 4, 5). The flap ages with the patient, and the perforator flaps preserve natural function of muscles. The procedure involves microsurgical techniques; hence, it is tolerated longer and better by young, healthy patients.Fig. 4


MR imaging of the reconstructed breast: What the radiologist needs to know.

Dialani V, Lai KC, Slanetz PJ - Insights Imaging (2012)

a The DIEP flap is supplied by intramuscular perforators from the deep inferior epigastric artery and vein. b Axial fat-saturated T1W images with post-contrast gadolinium injection. c 3D reformatted axial image show replacement of the normal glandular tissue of the breast with lower abdominal fat and the anastomosis of the vascular pedicle (arrow) by microsurgical technique to the internal mammary artery. For comparison, note the normal glandular tissue in the left breast
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3369124&req=5

Fig4: a The DIEP flap is supplied by intramuscular perforators from the deep inferior epigastric artery and vein. b Axial fat-saturated T1W images with post-contrast gadolinium injection. c 3D reformatted axial image show replacement of the normal glandular tissue of the breast with lower abdominal fat and the anastomosis of the vascular pedicle (arrow) by microsurgical technique to the internal mammary artery. For comparison, note the normal glandular tissue in the left breast
Mentions: Perforator flaps allow the transfer of the patient’s own skin and fat in a reliable manner with minimal donor-site morbidity. During flap harvest, these perforators are meticulously dissected free from the surrounding muscle, which is spread in the direction of the muscle fibers and preserved intact. The pedicle is anastomosed to recipient vessels in the chest, and the donor site is closed without the use of mesh or other materials [6–8] (Figs. 4, 5). The flap ages with the patient, and the perforator flaps preserve natural function of muscles. The procedure involves microsurgical techniques; hence, it is tolerated longer and better by young, healthy patients.Fig. 4

Bottom Line: Surgical management of breast cancer often entails lumpectomy or mastectomy.In this article, we will review the more commonly encountered types of breast reconstruction, which include implants, tranversus rectus abdomnis flap, latissimus dorsi flap, deep inferior epigastric perforator flap, and gluteal flaps.Radiologists will better understand the different types of breast reconstruction after mastectomy and their normal imaging appearance on MRI.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Beth Israel Deaconess Medical Center, C/o Dr. Vandana Dialani, 330 Brookline Avenue, Boston, MA, 02215, USA, vdialani@bidmc.harvard.edu.

ABSTRACT

Objective: The objective is to review the different types of breast reconstruction following cancer surgery and describe expected imaging appearances and complications seen in the reconstructed breast.

Methods: Surgical management of breast cancer often entails lumpectomy or mastectomy. When mastectomy is performed, patients often opt for breast reconstruction. Most facilities do not routinely image the reconstructed breast with mammography.

Results: However, many of these women are imaged with screening breast MRI for evaluation of the contralateral breast, or they may develop a clinical problem that warrants a diagnostic evaluation with MRI. In this article, we will review the more commonly encountered types of breast reconstruction, which include implants, tranversus rectus abdomnis flap, latissimus dorsi flap, deep inferior epigastric perforator flap, and gluteal flaps. Each of these types of reconstruction has different appearances on MR. We will also discuss potential complications that can be seen in the reconstructed breasts, including fat necrosis and recurrence.

Conclusion: Radiologists will better understand the different types of breast reconstruction after mastectomy and their normal imaging appearance on MRI. Radiologists will be more aware of how to recognize complications related to surgery as well as how to determine whether recurrence is present.

Main messages: • The different surgical techniques used in breast reconstruction are discussed. • Describes the normal magnetic resonance imaging appearance of the breast after reconstruction. • Identify MR imaging features of benign sequelae and recurrence following breast reconstruction.

No MeSH data available.


Related in: MedlinePlus