title: First experience using contrast-enhanced ultrasound to evaluate vascularisation of acellular dermal matrices after implant-based breast reconstruction.
abstract: Acellular dermal matrices (ADM) have been used frequently in therapeutic and prophylactic breast procedures. To date there have been no reports on vascularisation of ADMs and formation of tissue around them as seen with modern non-invasive imaging techniques such as contrast-enhanced ultrasound (CEUS). In this case series, we used CEUS to investigate the features of ADM in relation to vascular ingrowth and scaffold for "new" tissue formation. This is a retrospective evaluation of patients who underwent successful skin- and nipple-sparing mastectomy (SSM, NSM) with immediate IBBR using ADM from May 31, 2010, through December 28, 2012. Over a 24-month period, 16 patients, with an average age of 44 years (range 27-70 years), were evaluated with CEUS. No contrast agent allergies or side effects were reported for the ultrasound examination. After contrast agent injection (1-18 months postoperatively), homogeneous normal enhancement in the ADM and peripheral region with physiological tissue formation was seen in all patients. In this small study, the most obvious contribution of CEUS is the in vivo evaluation of vascular ingrowth and tissue formation after IBBR with ADM after follow-up of 1-18 months postoperatively.
  
  
  METHODS
  Retrospective cohort or comparative study; case-control study; or systematic review of these studies.
authors.affiliation: Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
authors.forename: Daryousch
authors.initials: D
authors.lastname: Parvizi
authors.forename: Franz
authors.initials: F
authors.lastname: Haas
authors.forename: Florentia
authors.initials: F
authors.lastname: Peintinger
authors.forename: Martin
authors.initials: M
authors.lastname: Hubmer
authors.forename: Thomas
authors.initials: T
authors.lastname: Rappl
authors.forename: Horst
authors.initials: H
authors.lastname: Koch
authors.forename: Michael
authors.initials: M
authors.lastname: Schintler
authors.forename: Stephan
authors.initials: S
authors.lastname: Spendel
authors.forename: Lars-Peter
authors.initials: LP
authors.lastname: Kamolz
authors.forename: Paul
authors.initials: P
authors.lastname: Wurzer
authors.forename: Alexandru
authors.initials: A
authors.lastname: Tuca
authors.forename: Michael
authors.initials: M
authors.lastname: Fuchsjaeger
authors.forename: Roland
authors.initials: R
authors.lastname: Weinke
mesh_terms: D062088:Acellular Dermis; D000328:Adult; D000368:Aged; D001940:Breast / Q000098:blood supply*; D019928:Breast Implantation; D018427:Breast Implants; D003287:Contrast Media; D005260:Female; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D016217:Ultrasonography, Mammary; D014945:Wound Healing
chemical_list: D003287:Contrast Media
keywords: ADM; CEUS; IBBR; NSM; SSM; breast reconstruction; mastectomy