Is Breast Magnetic Resonance Imaging Superior to Sonography in Gynecomastia Evaluation and Surgery Planning
Tóm tắt
Data on the value of magnetic resonance imaging (MRI) in the preoperative evaluation and surgery planning of gynecomastia are limited. The purpose of this study is to reveal MRI features and categories of gynecomastia and compare surgical outcomes following MRI and sonography as well as their diagnostic accuracy. The area of the gland and the whole breast on the transverse plane via nipple of MRI were measured to calculate the ratio between them. Areola, mass and branch patterns were categorized to represent three different gynecomastia type on MRI. 183 patients were included, with 38 in MRI group and 145 in sonography group. Diagnostic accuracy was assessed by the level of agreement between preoperative imaging findings and intraoperative observations. Surgical data, patients’ satisfaction and complications were compared between the two groups. MRI in 75 gynecomastic breasts demonstrated the average ratio of the gland to the whole breast was 10.6%±13.3%. The most common MRI categories were branch patterns (45.3%). The diagnostic concordance rate of MRI was higher than sonography (100% vs. 86.8%, p = 0.001). Among those junior surgeons, the length of surgery was reduced in MRI group (100 min vs. 115 min, p = 0.048). There was no difference in terms of patient’s satisfaction and complication rate between MRI and sonography. MRI was superior to sonography in diagnostic accuracy to assess the tissue components of gynecomastia and provided informative guidance especially for junior surgeons. Surgical outcomes were comparable regardless of the use of MRI or sonography for evaluation. IThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors
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Tài liệu tham khảo
Kanakis GA, Nordkap L, Bang AK, Calogero AE, Bartfai G, Corona G, Forti G, Toppari J, Goulis DG, Jorgensen N (2019) EAA clinical practice guidelines-gynecomastia evaluation and management. Andrology 7(6):778–793. https://doi.org/10.1111/andr.12636
Patterson SK, Helvie MA, Aziz K, Nees AV (2006) Outcome of men presenting with clinical breast problems: the role of mammography and ultrasound. Breast J 12(5):418–423. https://doi.org/10.1111/j.1075-122X.2006.00298.x
Telegrafo M, Introna T, Coi L, Cornacchia I, Rella L, Stabile Ianora AA, Angelelli G, Moschetta M (2016) Breast US as primary imaging modality for diagnosing gynecomastia. G Chir 37(3):118–122. https://doi.org/10.11138/gchir/2016.37.3.118
Dialani V, Baum J, Mehta TS (2010) Sonographic features of gynecomastia. J Ultrasound Med 29(4):539–547. https://doi.org/10.7863/jum.2010.29.4.539
Simon BE, Hoffman S, Kahn S (1973) Classification and surgical correction of gynecomastia. Plast Reconstr Surg 51(1):48–52. https://doi.org/10.1097/00006534-197301000-00009
Braunstein GD (2007) Clinical practice gynecomastia. N Engl J Med 357(12):1229–1237. https://doi.org/10.1056/NEJMcp070677
Blau M, Hazani R, Hekmat D (2016) Anatomy of the gynecomastia tissue and its clinical significance. Plast Reconstr Surg Glob Open 4(8):e854. https://doi.org/10.1097/GOX.0000000000000844
Gunhan-Bilgen I, Bozkaya H, Ustun E, Memis A (2002) Male breast disease: clinical, mammographic, and ultrasonographic features. Eur J Radiol 43(3):246–255. https://doi.org/10.1016/s0720-048x(01)00483-1
Adibelli ZH, Oztekin O, Gunhan-Bilgen I, Postaci H, Uslu A, Ilhan E (2010) Imaging characteristics of male breast disease. Breast J 16(5):510–518. https://doi.org/10.1111/j.1524-4741.2010.00951.x
Appelbaum AH, Evans GF, Levy KR, Amirkhan RH, Schumpert TD (1999) Mammographic appearances of male breast disease. Radiographics 19(3):559–568. https://doi.org/10.1148/radiographics.19.3.g99ma01559
Morakkabati-Spitz N, Schild HH, Leutner CC, von Falkenhausen M, Lutterbey G, Kuhl CK (2006) Dynamic contrast-enhanced breast MR imaging in men: preliminary results. Radiology 238(2):438–445. https://doi.org/10.1148/radiol.2382041312
Matarasso A (2000) Suction mammaplasty: the use of suction lipectomy to reduce large breasts. Plast Reconstr Surg 105(7):2604–2607; discussion 2608–2610. https://doi.org/10.1097/00006534-200006000-00053
Cigna E, Tarallo M, Fino P, De Santo L, Scuderi N (2011) Surgical correction of gynecomastia in thin patients. Aesthetic Plast Surg 35(4):439–445. https://doi.org/10.1007/s00266-010-9618-3
Billa E, Kanakis GA, Goulis DG (2021) Imaging in gynecomastia. Andrology 9(5):1444–1456. https://doi.org/10.1111/andr.13051
Hammond DC, Arnold JF, Simon AM, Capraro PA (2003) Combined use of ultrasonic liposuction with the pull-through technique for the treatment of gynecomastia. Plast Reconstr Surg 112(3):891–895; discussion 896–897. https://doi.org/10.1097/01.PRS.0000072254.75067.F7
Lista F, Ahmad J (2008) Power-assisted liposuction and the pull-through technique for the treatment of gynecomastia. Plast Reconstr Surg 121(3):740–747. https://doi.org/10.1097/01.prs.0000299907.04502.2f
Choi BS, Lee SR, Byun GY, Hwang SB, Koo BH (2017) The characteristics and short-term surgical outcomes of adolescent gynecomastia. Aesthetic Plast Surg 41(5):1011–1021. https://doi.org/10.1007/s00266-017-0886-z
Esme DL, Beekman WH, Hage JJ, Nipshagen MD (2007) Combined use of ultrasonic-assisted liposuction and semicircular periareolar incision for the treatment of gynecomastia. Ann Plast Surg 59(6):629–634. https://doi.org/10.1097/SAP.0b013e318038f762
Hodgson EL, Fruhstorfer BH, Malata CM (2005) Ultrasonic liposuction in the treatment of gynecomastia. Plast Reconstr Surg 116(2):646–653; discussion 654–655. https://doi.org/10.1097/01.prs.0000173441.57812.e8
Kim DH, Byun IH, Lee WJ, Rah DK, Kim JY, Lee DW (2016) Surgical management of gynecomastia: subcutaneous mastectomy and liposuction. Aesthetic Plast Surg 40(6):877–884. https://doi.org/10.1007/s00266-016-0705-y
Hoyos AE, Perez ME, Dominguez-Millan R (2021) Gynecomastia treatment through open resection and pectoral high-definition liposculpture. Plast Reconstr Surg 147(5):1072–1083. https://doi.org/10.1097/PRS.0000000000007901
Hoyos AE, Millard JA (2007) VASER-assisted high-definition liposculpture. Aesthet Surg J 27(6):594–604. https://doi.org/10.1016/j.asj.2007.08.007
Nagy MW, Vanek PF Jr (2012) A multicenter, prospective, randomized, single-blind, controlled clinical trial comparing VASER-assisted lipoplasty and suction-assisted lipoplasty. Plast Reconstr Surg 129(4):681e–689e. https://doi.org/10.1097/PRS.0b013e3182442274
Khalil AA, Ibrahim A, Afifi AM (2017) No-drain single incision liposuction pull-through technique for gynecomastia. Aesthetic Plast Surg 41(2):298–303. https://doi.org/10.1007/s00266-016-0749-z
Ozalp B, Berkoz O, Aydinol M (2018) Is the transposition of the nipple-areolar complex necessary in simon grade 2b gynecomastia operations using suction-assisted liposuction? J Plast Surg Hand Surg 52(1):7–13. https://doi.org/10.1080/2000656X.2017.1313260
Klinger M, Bandi V, Giannasi S, Caviggioli F, Veronesi A, Maione L, Catania B, Lisa A, Battistini A, Tinterri C, Testori A, Vinci V, Klinger F (2021) Gynecomastia: ultrasound-confirmed classification pertainent to surgical correction. Aesthetic Plast Surg 45(4):1397–1403. https://doi.org/10.1007/s00266-021-02187-6