乳腺MRI在乳腺癌保留乳头乳晕复合体Ⅰ期乳房重建中的应用

孙宇; 黎冠宏; 王存富; 董菊红; 钱朋飞; 闻国权; 邓素华

doi:10.19732/j.cnki.2096-6210.2023.03.007

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乳腺MRI在乳腺癌保留乳头乳晕复合体Ⅰ期乳房重建中的应用

论著 | 更新时间：2025-12-15

- 乳腺MRI在乳腺癌保留乳头乳晕复合体Ⅰ期乳房重建中的应用
- Application of breast MRI in stage Ⅰ breast reconstruction with nipple-areola complex-preserving in breast cancer
- 肿瘤影像学 2023年32卷第3期页码：256-261
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- DOI：10.19732/j.cnki.2096-6210.2023.03.007
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- 网络出版：2023-06-28，
  
  纸质出版：2023-06-28
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孙宇,黎冠宏,王存富,等. 乳腺MRI在乳腺癌保留乳头乳晕复合体Ⅰ期乳房重建中的应用[J]. 肿瘤影像学, 2023, 32(3): 256-261 https://doi.

org/10.19732/j.cnki.2096-6210.2023.03.007
孙宇,黎冠宏,王存富,等. 乳腺MRI在乳腺癌保留乳头乳晕复合体Ⅰ期乳房重建中的应用[J]. 肿瘤影像学, 2023, 32(3): 256-261 https://doi. DOI： 10.19732/j.cnki.2096-6210.2023.03.007.

org/10.19732/j.cnki.2096-6210.2023.03.007 DOI：

摘要

目的：

探究乳腺磁共振成像（magnetic resonance imaging，MRI）在乳腺癌保留乳头乳晕复合体（nipple-areola complex，NAC）Ⅰ期乳房重建中的应用价值。

方法：

选取惠州市第三人民医院75例乳腺癌患者，均行保留NAC Ⅰ期乳房重建。术前采用乳腺MRI评估乳房内肿瘤边缘与皮肤的距离、肿瘤边缘与NAC的距离，依据术前MRI测量数据评估皮下腺体切除的范围，计算计划切除组织体积，指导假体大小选择。并于术中测量乳房肿瘤边缘与皮肤的距离、肿瘤边缘与NAC的距离，测量术中实际切除组织体积、植入假体体积，比较MRI与术中测量数据，采用Pearson相关系数分析两组数据的线性关系，统计术后并发症发生情况、乳房重建美容效果。

结果：

乳腺MRI测量乳房内肿瘤边缘与皮肤的距离与术中测量比较，差异无统计学意义（

＞0.05），两者呈正相关（

=0.747，

＜0.05）；乳腺MRI测量肿瘤边缘与NAC的距离与术中测量比较，差异无统计学意义（

＞0.05），两者呈正相关（

=0.752，

＜0.05）；乳腺MRI测量计划切除组织体积与实际切除组织体积、植入假体体积比较，差异无统计学意义（

＞0.05），计划切除组织体积与实际切除组织体积、植入假体体积呈正相关（

=0.762、0.776，

＜0.05）；术后并发症总发生率为6.67%，主观美容效果优良率为86.67%，客观美容效果优良率为82.67%。

结论：

保留NACⅠ期乳房重建术前行乳腺MRI测量乳腺癌患者肿瘤位置、乳房内肿瘤边缘与皮肤的距离、肿瘤边缘与NAC的距离，可指导皮下腺体组织切除及假体大小选择，有利于术中安全保留部分乳房内部分脂肪组织，从而获得良好的乳房重建美容效果，减少术后并发症。

Abstract

Objective:

To explore the application value of breast magnetic resonance imaging (MRI) in breast reconstruction with nipple-areola complex (NAC)-preserving stage Ⅰ b

reast reconstruction.

Methods:

A total of 75 breast cancer patients in Huizhou Third Peoples Hospital were selected and all underwent NAC-preserving stage Ⅰ breast reconstruction. Before surgery

breast MRI was used to evaluate the thickness of fat in the breast

the thickness of the glands

and the distance from the tumor edge to the NAC. According to the preoperative MRI measurement data

the tumor resection range was determined

the planned tissue volume was calculated

and the size of the prosthesis was guided. During the operation

the thickness of the breast fat

the thickness of the glands

and the distance from the tumor edge to the NAC were measured

the volume of the tissues removed and the volume of the prosthesis was measured during operation

and the MRI and intraoperative measurement data were compared. The Pearson correlation coefficient model was used to analyze the two groups the linear relationship of the data

the statistics of postoperative complications

and the beauty effect of breast reconstruction.

Results:

There was no statistically significant difference between the distance of the tumor margin from the skin in the breast measured by breast MRI and intraoperative measurement (

＞0.05)

and the two were positively correlated (

=0.747

＜0.05). Breast MRI measured gland thickness was compared with intraoperative measurement

and the difference was not statistically significant (

＞0.05)

and the two were positively correlated (

=0.744

＜0.05).The distance between the tumor edge and the NAC measured by breast MRI was not statistically significant (

＞0.05)

the two were positively correlated (

=0.752

＜0.05). There was no statistically significant difference between the planned resected tissue volume measured by breast MRI and the actual resected tissue volume and the implanted prosthesis volume (

＞0.05). The planned resected tissue volume was positively correlated with

the volume of the actual tissue removed and the volume of the implant (

=0.762

0.776

＜0.05). The total incidence of postoperative complications was 6.67%

and the excellent rate of subjective cosmetic effect was 86.67%

and the objective cosmetic effect was excellent the rate is 82.67%.

Conclusion:

Before the NAC-preserving stage Ⅰ breast reconstruction

breast MRI can be used to measure the tumor location

breast fat thickness

gland thickness

and distance between tumor edge and NAC in breast cancer patients

which can guide tumor tissue resection and prosthesis size selection

which facilitates the safe preservation of part of the fatty tissue in part of the breast during the operation

so as to obtain a good beauty result of breast reconstruction and reduce postoperative complications.

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