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

摘要： 目的 分析动态增强MRI评估女性患者乳头乳晕复合体（NAC）的血供分布情况,为手术切口设计及NAC血管保护提供个体化解剖依据。方法 本研究回顾性收集2020年1月至2021年12月在深圳市宝安区妇幼保健院进行乳腺MRI检查的女性患者的临床资料与乳腺动态增强MRI图像信息,通过MRI轴位、冠状位、矢状位最大密度投影（MIP）图像结合三维MIP图像识别NAC所有供应血管。将NAC血供来源分为内上、内侧、内下、上方、中央区、下方、外上、外侧、外下9个供区。结果 本研究中198例患者共396只乳房（患病乳房211只,健康乳房185只）。双侧乳房NAC供血来源为单供区84只（21.2%）,双供区207只（52.3%）,三区及以上105只（26.5%）。患病乳房与正常乳房血供分布特征差异无统计学意义（P>0.05）。双侧乳房NAC共发现830条血管,其中来自内上346（41.7%）,内侧102（12.3%）,内下66（8.0%）,上方7（0.8%）,中央区9（1.1%）,下方17（2.0%）,外上251（30.2%）,外侧8（1.0%）,外下24（2.9%）。结论 术前乳腺MRI检查可为患者提供NAC供血信息。NAC的供血主要来源于内上、外上象限,并且大多数乳房的NAC供血来源为双区域及以上。

关键词: 乳头乳晕复合体, MRI 血管, 乳头坏死, 手术切口