Background: Breast reconstruction (BR) following mastectomy plays a critical role in restoring breast contour and improving patients’ quality of life. Acellular dermal matrices (ADMs) have emerged as valuable adjuncts in BR, providing structural support and enhancing soft tissue integration. However, their radiological characteristics remain underexplored, leading to potential misinterpretation and diagnostic challenges. This study aims to evaluate the imaging features of ADM in post-mastectomy patients using conventional imaging modalities, identifying its temporal evolution and clinical implications for radiologists and surgeons. Materials and Methods: This single-centre retrospective study included breast cancer patients who underwent mastectomy followed by ADM-assisted BR. Patients were monitored using standardised radiological follow-up protocols, including digital mammography (DM) and ultrasound (US), at 6 (T0), 12 (T1), and 18 months (T2) postoperatively. The primary outcomes assessed were the presence and evolution of ADM-related imaging findings, differentiation between normal ADM integration and pathological changes, and the role of different imaging modalities in ADM evaluation. Results: Sixty-three patients met the inclusion criteria and underwent radiological follow-up. At T0, ADM was identified in 16% of cases, primarily as a peri-capsular hypoechoic thickening on US and a linear peri-implant density on DM. At T1, these findings were partially resolved, with 11% of cases still displaying peri-capsular changes. By T2, imaging signs of ADM were further reduced, with only 7% of cases showing residual peri-capsular thickening or pseudonodular formations. No ADM-related complications, graft rejection, or implant loss were detected. These findings suggest a progressive integration of ADM into the host tissue over time, with characteristic imaging changes that must be recognised to avoid misdiagnosis or unnecessary interventions. Conclusions: ADM exhibits a dynamic radiological evolution in post-mastectomy BR, with its imaging characteristics gradually fading. Recognising these features is critical for radiologists and surgeons to ensure accurate interpretation and optimised patient management. A structured imaging follow-up protocol, incorporating US as the primary modality and MRI in cases of inconclusive findings, is recommended to improve diagnostic accuracy. Future multicentre studies with extended follow-up and advanced imaging techniques are necessary to refine radiological criteria and further explore ADM integration patterns. A multidisciplinary approach is essential to enhance clinical decision-making, reduce unnecessary interventions, and optimise patient outcomes in ADM-assisted BR.
背景：乳房切除术后乳房重建（BR）对于恢复乳房轮廓及改善患者生活质量具有关键作用。脱细胞真皮基质（ADM）已成为BR中的重要辅助材料，可提供结构支撑并促进软组织整合。然而，其影像学特征尚未得到充分研究，可能导致误判和诊断困难。本研究旨在通过常规影像学方法评估乳房切除术后患者ADM的影像学特征，明确其随时间演变的规律，并为放射科医生和外科医生提供临床指导。 材料与方法：本单中心回顾性研究纳入接受乳房切除术后ADM辅助BR的乳腺癌患者。术后6个月（T0）、12个月（T1）和18个月（T2）采用标准化影像学随访方案进行监测，包括数字乳腺X线摄影（DM）和超声（US）。主要评估指标包括ADM相关影像学表现的存在及演变、正常ADM整合与病理改变的鉴别，以及不同影像学方法在ADM评估中的作用。 结果：63例患者符合纳入标准并完成影像学随访。T0时，16%的病例可识别ADM，主要表现为US下的包膜周围低回声增厚和DM下的植入物周围线性致密影。T1时，这些表现部分消退，11%的病例仍显示包膜周围改变。至T2时，ADM的影像学征象进一步减少，仅7%的病例存在残余包膜周围增厚或假结节形成。未发现ADM相关并发症、移植物排斥或植入物脱落。这些结果表明ADM随时间推移逐渐整合入宿主组织，其特有的影像学变化需被准确识别，以避免误诊或不必要干预。 结论：ADM在乳房切除术后BR中呈现动态的影像学演变过程，其影像特征随时间逐渐消退。放射科医生和外科医生准确识别这些特征对于确保正确解读影像和优化患者管理至关重要。建议建立结构化影像随访方案，以US为主要检查手段，在结果不明确时结合MRI，以提高诊断准确性。未来需开展多中心长期随访研究，结合先进影像技术，以完善ADM的影像学评估标准并深入探索其整合模式。多学科协作对于提升ADM辅助BR的临床决策水平、减少不必要干预及优化患者预后具有重要意义。
肿瘤(癌症)患者之家