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MRI analysis of chronological changes in free-flap volume in head and neck reconstruction by volumetry
Yuki Sakamoto1, Taro Takahara, Yoshihide Ota
1Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. yukiyama20@hotmail.com.
Objective:
To evaluate changes in flap volumes for head and neck cancer patients by MRI.
Methods:
MRI examinations of a total of 21 head and neck cancer patients (13 males and 8 females; average age, 67 years) were performed after surgery to monitor changes in flap volumes, including muscle and fat content, using volumetric analysis of T2-weighted images at 1, 3, 6, and 12 months after surgery.
Results:
Fat-to-muscle ratios of all flaps at 1 month varied (muscle/fat ratio, 0.04-0.96). Flap volumes in all patients decreased at 12 months after surgery. The average final volumes of overall, muscle, and fat volumes reached 76.9% ± 5.2%, 37.1% ± 3.7%, and 85.5% ± 5.7%, respectively. The average fat volume slightly increased between 6 and 12 months, whereas compared with the fat volume, the average muscle volume significantly decreased (p<0.001).
Conclusions:
The final overall flap volume in all patients decreased to approximately 25% of the original volume after surgery, which primarily resulted from muscle atrophy. Therefore fat-rich flaps may maintain flap volumes after surgery. MRI is a useful method to evaluate the size and shape of flaps of the head and neck.
