Limits...
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 GAP flaps are based on perforators from either the superior or inferior gluteal artery. Superior gluteal artery perforator (SGAP) flaps allow transfer of tissue from the buttock using the superior gluteal arty as a vascular pedicle for transfer of tissue. Inferior gluteal artery perforator (IGAP) flaps allow transfer of tissue from the buttock using the inferior gluteal artery as a vascular pedicle for transfer of tissue. b The transversus upper gracilis (TUG) flap procedure uses tissue from the inner portion of the upper thigh for breast reconstruction. c Axial nonfat-saturated T2W axial image showing, SGAP reconstruction with microvascular surgical anastomosis of the superior gluteal artery to the internal mammary artery (white arrow). For comparison, note the normal glandular tissue in the right breast. d Sagittal fat-saturated T1W image with dynamic gadolinium injection shows replacement of the normal glandular tissue of the breast with lower abdominal fat and the anastomosis of the vascular pedicle by microsurgical technique to the internal mammary artery (white arrow)
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3369124&req=5

Fig5: a GAP flaps are based on perforators from either the superior or inferior gluteal artery. Superior gluteal artery perforator (SGAP) flaps allow transfer of tissue from the buttock using the superior gluteal arty as a vascular pedicle for transfer of tissue. Inferior gluteal artery perforator (IGAP) flaps allow transfer of tissue from the buttock using the inferior gluteal artery as a vascular pedicle for transfer of tissue. b The transversus upper gracilis (TUG) flap procedure uses tissue from the inner portion of the upper thigh for breast reconstruction. c Axial nonfat-saturated T2W axial image showing, SGAP reconstruction with microvascular surgical anastomosis of the superior gluteal artery to the internal mammary artery (white arrow). For comparison, note the normal glandular tissue in the right breast. d Sagittal fat-saturated T1W image with dynamic gadolinium injection shows replacement of the normal glandular tissue of the breast with lower abdominal fat and the anastomosis of the vascular pedicle by microsurgical technique to the internal mammary artery (white arrow)

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 GAP flaps are based on perforators from either the superior or inferior gluteal artery. Superior gluteal artery perforator (SGAP) flaps allow transfer of tissue from the buttock using the superior gluteal arty as a vascular pedicle for transfer of tissue. Inferior gluteal artery perforator (IGAP) flaps allow transfer of tissue from the buttock using the inferior gluteal artery as a vascular pedicle for transfer of tissue. b The transversus upper gracilis (TUG) flap procedure uses tissue from the inner portion of the upper thigh for breast reconstruction. c Axial nonfat-saturated T2W axial image showing, SGAP reconstruction with microvascular surgical anastomosis of the superior gluteal artery to the internal mammary artery (white arrow). For comparison, note the normal glandular tissue in the right breast. d Sagittal fat-saturated T1W image with dynamic gadolinium injection shows replacement of the normal glandular tissue of the breast with lower abdominal fat and the anastomosis of the vascular pedicle by microsurgical technique to the internal mammary artery (white arrow)
© Copyright Policy
Related In: Results  -  Collection

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

Fig5: a GAP flaps are based on perforators from either the superior or inferior gluteal artery. Superior gluteal artery perforator (SGAP) flaps allow transfer of tissue from the buttock using the superior gluteal arty as a vascular pedicle for transfer of tissue. Inferior gluteal artery perforator (IGAP) flaps allow transfer of tissue from the buttock using the inferior gluteal artery as a vascular pedicle for transfer of tissue. b The transversus upper gracilis (TUG) flap procedure uses tissue from the inner portion of the upper thigh for breast reconstruction. c Axial nonfat-saturated T2W axial image showing, SGAP reconstruction with microvascular surgical anastomosis of the superior gluteal artery to the internal mammary artery (white arrow). For comparison, note the normal glandular tissue in the right breast. d Sagittal fat-saturated T1W image with dynamic gadolinium injection shows replacement of the normal glandular tissue of the breast with lower abdominal fat and the anastomosis of the vascular pedicle by microsurgical technique to the internal mammary artery (white arrow)
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