부산대학교 도서관

BACKGROUND:: Muscle flaps used in reconstructive surgery are known to lose volume over time due to denervation and disuse atrophy. However, there is currently no agreement on a quantitative approach to evaluating volume changes. Here, long-term serial measurement of muscle volume in transverse rectus abdominis musculocutaneous (TRAM) flap breast reconstruction has been conducted using the Eclipse™ Treatment planning system. METHODS:: This was a retrospective review of the medical records of patients who underwent unilateral immediate breast reconstruction using a pedicled TRAM flap between January 2004 and December 2007. Patients who completed three serial follow up computed tomography (CT) scans and did not have history of recurrence and/or radiation therapy were included. Eclipse™ software was used for segmentation and 3D reconstruction of the CT images; the volume of the pedicled rectus abdominis muscle was calculated and the contralateral side served as the control. RESULTS:: Among 451 undergoing TRAM flap surgery during the study period, 35 met the inclusion requirements. Serial measurement of rectus abdominis muscle volume of the flap showed a mean volume ratio of 27.1%, 22.1%, and 19.8% at 15, 30, and 51 months, respectively. The extrapolated volume ratio finally converged at 19.4%. Contralateral muscle volume did not change significantly over time. CONCLUSION:: The muscle of a TRAM flap loses > 70% of its volume in the first 15 months, ultimately reducing to approximately 20% of its original size. Eclipse can be utilized retrospectively for volume measurement after a variety of reconstructive procedures using CT or MRI images.