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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 57-year-old woman with TRAM flap reconstruction and nipple tattoo: a T1W fat-saturated contrast-enhanced and b) T2W nonfat-saturated images showing as an area of signal void along the nipple areola complex (arrows) because of the pigments used for nipple tattooing
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Fig7: A 57-year-old woman with TRAM flap reconstruction and nipple tattoo: a T1W fat-saturated contrast-enhanced and b) T2W nonfat-saturated images showing as an area of signal void along the nipple areola complex (arrows) because of the pigments used for nipple tattooing

Mentions: Nipple-areola reconstruction represents the completion of the breast restorative process and has significant psychological implications for women who undergo mastectomy. Complete nipple-areola reconstruction with tattoos can visually draw attention away from the scars on the reconstructed breast mound. The base powder, initially barium sulfate, was later replaced by titanium dioxide. Masser et al. introduced the pigment-gel-suspension technique in 1989, achieving more natural results by avoiding a painted appearance. The fine-particle pigments, when introduced into the dermis, resemble the distribution of natural skin pigments, such as melanin in melanocytes and hemoglobin in skin capillaries [12]. On MR imaging the tattoo produces a blooming artifact on the T1 and T2W images with a faint rim of discontinuous enhancement on the subtraction images (Fig. 7).Fig. 7


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

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

A 57-year-old woman with TRAM flap reconstruction and nipple tattoo: a T1W fat-saturated contrast-enhanced and b) T2W nonfat-saturated images showing as an area of signal void along the nipple areola complex (arrows) because of the pigments used for nipple tattooing
© Copyright Policy
Related In: Results  -  Collection

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

Fig7: A 57-year-old woman with TRAM flap reconstruction and nipple tattoo: a T1W fat-saturated contrast-enhanced and b) T2W nonfat-saturated images showing as an area of signal void along the nipple areola complex (arrows) because of the pigments used for nipple tattooing
Mentions: Nipple-areola reconstruction represents the completion of the breast restorative process and has significant psychological implications for women who undergo mastectomy. Complete nipple-areola reconstruction with tattoos can visually draw attention away from the scars on the reconstructed breast mound. The base powder, initially barium sulfate, was later replaced by titanium dioxide. Masser et al. introduced the pigment-gel-suspension technique in 1989, achieving more natural results by avoiding a painted appearance. The fine-particle pigments, when introduced into the dermis, resemble the distribution of natural skin pigments, such as melanin in melanocytes and hemoglobin in skin capillaries [12]. On MR imaging the tattoo produces a blooming artifact on the T1 and T2W images with a faint rim of discontinuous enhancement on the subtraction images (Fig. 7).Fig. 7

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