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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

Benign skin thickening post-TRAM flap breast reconstruction identified as a diffuse band of tissue that is bright on T1W unenhanced image, and as shown here no significant enhancement is seen on post-contrast T1W image. Note enhancement in the underlying vessels
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Fig6: Benign skin thickening post-TRAM flap breast reconstruction identified as a diffuse band of tissue that is bright on T1W unenhanced image, and as shown here no significant enhancement is seen on post-contrast T1W image. Note enhancement in the underlying vessels

Mentions: Radiation therapy causes vasodilatation and hinders venous outflow within the skin and subcutaneous tissues. Reconstruction may affect venous and lymphatic drainage, contributing further to fluid accumulation, especially with TRAM flap reconstruction [10]. On MR imaging, benign skin thickening can be identified as a diffuse band of tissue that is dark on T1-weighted images and bright on T2-weighted images, and usually does not show enhancement (Fig. 6). These findings are nonspecific, and tumor infiltration in inflammatory carcinoma can manifest similarly. Skin enhancement following radiation therapy is more uniform and less intense. Inflammatory cancer, however, has more marked skin enhancement, with underlying tumor enhancement in either a septal or solid pattern [11].Fig. 6


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

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

Benign skin thickening post-TRAM flap breast reconstruction identified as a diffuse band of tissue that is bright on T1W unenhanced image, and as shown here no significant enhancement is seen on post-contrast T1W image. Note enhancement in the underlying vessels
© Copyright Policy
Related In: Results  -  Collection

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

Fig6: Benign skin thickening post-TRAM flap breast reconstruction identified as a diffuse band of tissue that is bright on T1W unenhanced image, and as shown here no significant enhancement is seen on post-contrast T1W image. Note enhancement in the underlying vessels
Mentions: Radiation therapy causes vasodilatation and hinders venous outflow within the skin and subcutaneous tissues. Reconstruction may affect venous and lymphatic drainage, contributing further to fluid accumulation, especially with TRAM flap reconstruction [10]. On MR imaging, benign skin thickening can be identified as a diffuse band of tissue that is dark on T1-weighted images and bright on T2-weighted images, and usually does not show enhancement (Fig. 6). These findings are nonspecific, and tumor infiltration in inflammatory carcinoma can manifest similarly. Skin enhancement following radiation therapy is more uniform and less intense. Inflammatory cancer, however, has more marked skin enhancement, with underlying tumor enhancement in either a septal or solid pattern [11].Fig. 6

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