关键词: 乳头乳晕复合体, MRI 血管, 乳头坏死, 手术切口

Abstract: Objective The aim of this study was to evaluate the blood supply characteristics of the nipple-areolar complex （NAC） with dynamic contrast-enhanced MRI, and to provide an anatomical basis for the design of surgical incisions and intraoperative NAC vascular protection. Methods From January 2020 to December 2021, the breast magnetic resonance imaging data of 396 breasts in 198 female patients in Shenzhen Baoan Women's and Children's Hospital were collected retrospectively. The axial, coronal and sagittal maximum intensity projection （MIP） images were assessed, all the arteries supplying the NAC were identified by 3D MIP images. The blood supply sources of NAC were divided into 9 zones： superomedial, medial, inferomedial, superolateral, lateral, inferolateral, central, inferior, and superior. Results Of the 396 breasts（diseased breasts 221 and healthy breasts 185）, 84 （21.2%） were supplied by single region, 207（52.3%） by double region, and 105（26.5%） by three regions and above. The characteristics of the blood supply to the NAC did not differ significantly between diseased breasts and healthy breasts （P>0.05）. A total of 830 blood vessels were found, of which 346 （41.7%） were from superomedial, 102（12.3%） from medial, 66（8.0%） from inferomedial, 7（0.8%） from superior, and 9（1.1%） from central, 17（2.0%） from Inferior, 251（30.2%） from superolateral, 8 （1.0%） from lateral, 24（2.9%） from inferolateral. There was no significant difference in the number of NAC perfusion zones （P>0.05） and the distribution of source vessels （P>0.05）. Conclusion Preoperative breast MRI can dedicate clear information of blood supply to NAC. Blood vessels from the superomedial and superolateral zones were the predominant sources of blood supplying the NAC. Most NACs have dual-zone blood supply and above.

Key words: nipple-areola complex, magnetic resonance imaging, breast, nipple necrosis, incision choice