MRI analysis of chronological changes in free-flap volume in head and neck reconstruction by volumetry.
MRI analysis of chronological changes in free-flap volume in head and neck reconstruction by volumetry.
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2014-03
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通讯作者：
Y. Sakamoto;T. Takahara;Y. Ota;T. Aoki;H. Yamazaki;M. Otsuru;Miho Takahashi;Ken-ichi Aoyama;A. Kaneko;S. Kawada;T. Ichikawa;Kotaro Imagawa;M. Miyasaka
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作者：
Y. Sakamoto;T. Takahara;Y. Ota;T. Aoki;H. Yamazaki;M. Otsuru;Miho Takahashi;Ken-ichi Aoyama;A. Kaneko;S. Kawada;T. Ichikawa;Kotaro Imagawa;M. Miyasaka
目的 通过 MRI 评估头颈癌患者皮瓣体积的变化。方法 对 21 例头颈癌患者（男 13 例，女 8 例，平均年龄 67 岁）进行 MRI 检查，通过术后 1、3、6、12 个月的 T2 加权图像体积分析，监测皮瓣体积的变化，包括肌肉和脂肪含量。结果 1 个月时所有皮瓣的脂肪与肌肉比率各不相同（肌肉/脂肪比率，0.04-0.96）。所有患者的皮瓣体积在术后 12 个月时均有所减少。总体积、肌肉体积和脂肪体积的平均最终体积分别达到76.9%±5.2%、37.1%±3.7%和85.5%±5.7%。 6至12个月期间，平均脂肪体积略有增加，而与脂肪体积相比，平均肌肉体积显着下降（p<0.001）。结论 术后所有患者的最终皮瓣总体积减少至原始体积的 25% 左右，这主要是由于肌肉萎缩所致。因此，富含脂肪的皮瓣可以在术后保持皮瓣体积。 MRI 是评估头颈部皮瓣大小和形状的有用方法。
OBJECTIVE To evaluate changes in flap volumes for head and neck cancer patients by MRI. METHODS MRI examinations of a total of 21 head and neck cancer patients (13 males and 8 females; average age, 67 years) were performed after surgery to monitor changes in flap volumes, including muscle and fat content, using volumetric analysis of T2-weighted images at 1, 3, 6, and 12 months after surgery. RESULTS Fat-to-muscle ratios of all flaps at 1 month varied (muscle/fat ratio, 0.04-0.96). Flap volumes in all patients decreased at 12 months after surgery. The average final volumes of overall, muscle, and fat volumes reached 76.9% ± 5.2%, 37.1% ± 3.7%, and 85.5% ± 5.7%, respectively. The average fat volume slightly increased between 6 and 12 months, whereas compared with the fat volume, the average muscle volume significantly decreased (p<0.001). CONCLUSIONS The final overall flap volume in all patients decreased to approximately 25% of the original volume after surgery, which primarily resulted from muscle atrophy. Therefore fat-rich flaps may maintain flap volumes after surgery. MRI is a useful method to evaluate the size and shape of flaps of the head and neck.