• Title/Summary/Keyword: 유방재건

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Classification of Deep Inferior Epigastric Perforator Courses Based on Computed Tomography Angiography: Incidences and Clinical Implications (컴퓨터 단층 촬영 혈관 조영술을 이용한 심하복벽 혈관과 천공지의 박리 용이성에 따른 분류)

  • Lee, Yeonhoon;Kim, Sung Chan;Eom, Jin Sup;Kim, Eun Key
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.281-289
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    • 2018
  • Purpose: Preoperative surgical planning utilizing computed tomography angiography (CTA) has now become a routine in many practices. We analyzed the course of the deep inferior epigastric artery (DIEA) and its perforators (DIEP) that would either facilitate or hinder flap dissection based on CTA to aid surgical planning. Methods: The 115 consecutive patients who underwent abdominally based free flap breast reconstruction were enrolled in this prospective study. DIEA/P courses were categorized mainly according to their intramuscular courses and their incidences were investigated. Results: A total of 425 perforators were identified preoperatively on the CTA, with an average number of 3.7 distinctly visualized in the entire flap territory. Eighty-nine perforators (20.9%) had a favorable (less than 1 cm intramuscular course) pattern, namely long submuscular (34.8% of the patients), long subfascial (15.6%), and total circummuscular (13.9%). Overall 56.5% of the patients had at least one favorable DIEA/P. On the other hand, absence of DIEA and absence of adequate (>1 mm) DIEP was reported in 3 and 8 hemiabdomen. Conclusion: Preoperative CTA evaluation of DIEA/P can be used to identify favorable as well as unfavorable courses for dissection to aid surgical planning.

Evaluation of artifacts around the breast expander according to magnetic field strength (자장의 세기에 따른 유방 확장기 주위의 인공물 평가)

  • Jung, Dong- Il;Kim, Jae-Seok
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.24 no.9
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    • pp.1144-1149
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    • 2020
  • The magnetic valve of the breast tissue expander generates imaging artifacts during MRI examination, so MRI examination is limited. To evaluate the effect of imaging artifacts on the diagnosis area for patients with breast tissue expander who need MRI examination. Imaging artifacts were measured using self-made phantoms and actual clinical conditions. Imaging artifacts were measured differently depending on the environment of 1.5 Tesla and 3.0 Tesla, and the effects of imaging artifacts were less in the C-spine and L-spine tests. If MRI due to breast cancer metastasis is absolutely necessary, head & neck examination and L-spine can be examined mainly at 1.5 Tesla, but some sequences may cause distortion due to image artifacts. In terms of safety, MRI scans of patients with breast tissue expanders can be performed conditionally at 1.5T, avoiding 3.0T.

Evaluation of Usefulness of Image by Using New Compression Paddle for Mammoplasty Patient During Mammography (유방촬영 시 유방보형물 환자에 대한 새로운 압박대 적용의 유용성 평가)

  • Hong, Dong-Hee
    • Journal of radiological science and technology
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    • v.38 no.3
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    • pp.229-235
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    • 2015
  • Mammoplasty is currently increasing not only for cosmetic surgery, but as well as for the recovery after breast cancer surgery. The prostheses inserted into the breasts of women who have undergone mammoplasty, hide the breast substances and it is becoming increasingly difficult to diagnose breast disease, and fear is growing by the concern of the prostheses bursting by the strap. So we want to develop a strap applicable to women with prostheses inserted, to determine the usefulness, and we also want to compare the utility by comparing the total area of the Inner and Outer parts of the breast and Posterior Nipple Line (PNL), after obtaining video by applying the existing strap and the developed strap to phantom of the prostheses inserted patient shape. When the pressure by the developed pressure, the total area increased by 10.09% from CC view to $9,813.797mm^2$, 3.88% from CC-ID view to $7,621.531mm^2$, PNL increased by 3.41% from CC view to $90.916mm^2$, 1.64% from CC-ID view to$75.357mm^2$. And the breast tissue of the thorax side increased 3.53% from CC view to $177.725mm^2$, and 6.57% from CC-ID view to $152.510mm^2$, and we could verify that the prostheses were completely eliminated in the CC-ID images of developed strap, compared with the existing strap.

Evaluation of MR Safety of Breast Expander on 1.5T and 3.0T MRI (유방 조직 확장기의 1.5T와 3.0T MRI 환경 내 안정성 평가)

  • Jung, Dong-Il;Kim, Jae-Seok
    • Journal of the Korean Society of Radiology
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    • v.14 no.4
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    • pp.361-366
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    • 2020
  • The purpose of this study is to evaluate the safety of the breast tissue expander implanted patients who require MRI examination. Torques were 0ml, 150 ml, 300 ml, 450 ml at 1.5 Tesla forward direction, 4, 3, 3, and 2 respectively, and 1.5 Tesla reverse direction at 4, 4, 4, 3 respectively. In the 3.0 T environment, 4 was shown in all conditions. In the overturning experiment, no overturning occurred in more than 300 ml in the 1.5Tesla environment, and most of the overturning occurred in the 3.0 Tesla environment. In terms of safety, MRI scans of patients with breast tissue expanders should be avoided at 3.0 Tesla and conditionally at 1.5 Tesla.

Usefulness of Three-Dimensional Maximal Intensity Projection (MIP) Reconstruction Image in Breast MRI (유방자기공명영상에서 3 차원 최대 강도 투사 재건 영상의 유용성)

  • Kim, Hyun-Sung;Kang, Bong-Joo;Kim, Sung-Hun;Choi, Jae-Jeong;Lee, Ji-Hye
    • Investigative Magnetic Resonance Imaging
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    • v.13 no.2
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    • pp.183-189
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    • 2009
  • Purpose : To evaluate the usefulness of three-dimensional (3D) maximal intensity projection (MIP) reconstruction method in breast MRI. Materials and Methods : Total 54 breasts of consecutive 27 patients were examined by breast MRI. Breast MRI was performed using GE Signa Excite Twin speed (GE medical system, Wisconsin, USA) 1.5T. We obtained routine breast MR images including axial T2WI, T1WI, sagittal T1FS, dynamic contrast-enhanced T1FS, and subtraction images. 3D MIP reconstruction images were obtained as follows; subtraction images were obtained using TIPS and early stage of contrast-enhanced TIPS images. And then 3D MIP images were obtained using the subtraction images through advantage workstation (GE Medical system). We detected and analyzed the lesions in the 3D MIP and routine MRI images according to ACR $BIRADS^{(R)}$ MRI lexicon. And then we compared the findings of 3D MIP and those of routine breast MR images and evaluated whether 3D MIP had additional information comparing to routine MR images. Results : 3D MIP images detect the 43 of 56 masses found on routine MR images (76.8%). In non-mass like enhancement, 3D MIP detected 17 of 20 lesions (85 %). And there were one hundred sixty nine foci at 3D MIP images and one hundred nine foci at routine MR images. 3D MIP images detected 14 of 23 category 3 lesions (60.9%), 11 of 16 category 4 lesions (68.87%), 28 of 28 Category 5 lesions (100%). In analyzing the enhancing lesions at 3D MIP images, assessment categories of the lesions were correlated as the results at routine MR images (p-value < 0.0001). 3D MIP detected additional two daughter nodules that were descriped foci at routine MR images and additional one nodule that was not detected at routine MR images. Conclusion : 3D MIP image has some limitations but is useful as additional image of routine breast MR Images.

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Various Abdominal Flaps for Breast Reconstruction: Pedicled TRAM, Free TRAM, Muscle-sparing TRAM, DIEP, and SIEA Flaps (유방재건에 이용되는 복부 피판 : 유경 TRAM, 유리 TRAM, MS-TRAM, DIEP, SIEA 피판)

  • Lee, Jun-Ho
    • Journal of Yeungnam Medical Science
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    • v.28 no.2
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    • pp.116-123
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    • 2011
  • The incidence of breast cancer, the second most prevalent cancer type in South Korea, has increased by 6.8% annually in the last six years. The higher number of breast cancer patients has led to an increase in the cases of skin-sparing mastectomies, thereby increasing the need for reconstructive procedures. The reconstruction options include alloplastic techniques such as implant or autologous reconstruction with numerous flaps. The abdominal area is the preferred donor site for the harvest of autologous tissue for breast reconstruction. Breast reconstruction using abdonimal tissue is commonly accomplished using the transverse rectus abdominis myocutaneous (TRAM) flap. The establishment of microvascular surgery led to the development of the free TRAM flap because of its increased vascularity and decreased rectus abdominis sacrifice. The muscle-sparing TRAM, DIEP, and SIEA flap techniques were later developed in an effort to decrease the abdominal-donar-site morbidity by decreasing the injury to the rectus abdominis muscle and fascia. This article summarizes the various abdominal flaps for breast reconstruction.

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Mondor's Disease after Immediate Breast Reconstruction with Silicone Implant (실리콘 보형물을 이용한 즉시 유방재건 후 발생한 Mondor's Disease 치험례)

  • Sun, Sang-Hoon;Lee, Taik-Jong
    • Archives of Plastic Surgery
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    • v.37 no.1
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    • pp.87-90
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    • 2010
  • Purpose: Mondor's disease is commonly known as a benign breast condition after augmentation mammaplasty, and some authors have also reported its association with other breast surgeries such as reduction mammaplasty or axillary lymph node biopsy. Here we report two cases of Mondor's disease after immediate breast reconstruction with silicone implant. Methods: Two women, 51-year-old and 36-year-old, underwent immediate breast reconstruction with silicone implants after nipple-areolar skin-sparing mastectomy. Results: Subcutaneous cord-like firm lesion appeared on upper abdomen, axillary area following surgery. The lesion was painless and spontaneously subsided with no medications. Conclusion: To our knowledge, this is the first report of Mondor's disease developed after immediate breast reconstruction using silicone implant.