Preoperative visualization of mammary artery for breast reduction surgery based on computed tomography angiography

Abstract

Background Macromastia, characterized by an increase in breast size, poses challenges such as elevated body burden and chest oppression, potentially leading to cardiac and pulmonary overload. A crucial aspect of addressing these challenges involves preoperative planning, aiming to acquire detailed images and a 3D model of the internal mammary artery with minimal radiation exposure. Purpose This study aimed to explore the clinical significance of computed tomography angiography (CTA) of the mammary artery in preoperative planning for breast reduction surgery. Methods Retrospective analysis was conducted on CT images from 60 patients scheduled for breast reduction surgery in the plastic surgery department. These images were processed using a post-processing workstation to extract internal mammary arteries for subsequent 3D modeling. Radiologists and plastic surgeons collaborated to perform preoperative planning based on the 3D model and associated measurement parameters. Subsequent follow-up examinations occurred 4 to 9 months post-surgery, evaluating necrosis rates and complications of the nipple-areola complex (NAC). Results A total of 206 blood vessels were reconstructed and extracted in 60 patients, including 156 main arteries and 50 arterioles. There were no instance of NAC necrosis, complications, or infections in the 4–9 months follow-up period. Conclusions Preoperative Mammary artery CTA emerged as a valuable tool, facilitating a comprehensive understanding of the internal mammary arteries and the primary blood supply in the NAC region. This approach effectively minimizes the risk of NAC supply artery injury during surgery, thereby preserving the functionality of the nipple and areola.