李晟 傅荣

[摘要]目的：探讨磁共振成像技术结合线性测量法在乳腺癌术后一期假体置入乳房再造中的临床应用价值。方法：共纳入34例乳腺癌患者，采用磁共振成像技术结合线性测量法测量乳房，选取合适规格大小的假体。术后随访6～24个月，分析患者双侧乳房对称性指标、美容效果及术后并发症情况。结果：患者患侧与健侧乳房相关对称性参数（SN-N、C-N、N-M、MBW、N-IMF）比较差异不具有统计学意义（P>0.05）。主观美容效果评价采用Harris评价方法，美观率为84.85%;客观美容效果评价采用泽井法标准，美观率为81.82%。患者术后生存率100.00%，并发症发生率为8.82%。结论：磁共振成像技术结合线性测量法可较准确地测量乳房腺体体积、所需假体基底直径、纵径及凸度，提供较为完整的乳房再造术前信息，可作为乳腺癌术后一期假体置入乳房再造中选择合适假体的一种参考方法。

[关键词]乳房再造;假体隆乳术;乳腺癌;磁共振成像

[中图分类号]R737.9    [文献标志码]A    [文章编号]1008-6455（2021）01-0024-04

Application of MRI Combined with Linear Measurement in Primary Breast Reconstruction Prosthesis Implantation after Breast Cancer Surgery

LI Sheng1，2，FU Rong3

（1.Zunyi Medical University，Zunyi 563003，Guizhou，China;2.Department of Plastic Surgery，Guangyuan Central Hospital，Guangyuan 628000，Sichuan，China;3.Department of Plastic Surgery，Sichuan Academy of Medical Sciences，Sichuan Provincial Peoples Hospital，Chengdu 610072，Sichuan，China）

Abstract： Objective  To explore the application of MRI combine with linear measurement in primary breast reconstruction prosthesis implantation after breast cancer surgery. Methods  A total of 34 patients with breast cancer were included. The breast was measured by magnetic resonance imaging （MRI） combined with linear measurement， and the prosthesis with appropriate size was selected. The patients all were followed up for 6-24 months，the date of breast symmetry， cosmetic result and complications were recorded and analysed. Results  There were no significant difference in symmetry parameters （SN-N， C-N， N-M， MBW， N-IMF） between the affected side and the contralateral side（P>0.05）. In the subjective evaluation， using Harris questionnaire， the aesthetic rate was 84.85%. In the objective evaluation，using Zejin standard， the aesthetic rate was 81.82%. The postoperative survival rate was 100.00%， and the incidence of postoperative complications was 8.82%. Conclusion  The application of MRI combine with linear measurement can effectively measure the volume of breast， height， width and convexity， which has clinical application， and can be considered as a reference method in the immediate implant breast reconstruction surgery.

Key words： breast reconstruction; augmentation mammoplasty with prosthesis; breast cancer; magnetic resonance imaging（MRI）

乳腺癌是女性最常見的恶性肿瘤之一，我国乳腺癌发病率居女性恶性肿瘤第二位，且呈逐年上升及年轻化趋势，2008年-2015年乳腺癌的发病率及死亡率增加了近18%[1-3]。一期假体置入乳房再造术的目的是为乳房切除的患者重塑一对美观对称的乳房，因此选择合适的假体尤为重要，迄今为止，选择合适体积及形态的假体仍是乳房再造术的难点。假体的外观类似乳房，选择假体时不仅只关注体积大小，而且必须兼顾横径（基底直径）、凸度和纵径这些因素[4-6]。本研……