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Related Concept Videos

Papillary Dermis01:11

Papillary Dermis

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Dermis
The dermis might be considered the "core" of the integumentary system, as distinct from the epidermis and hypodermis. It contains blood and lymph vessels, nerves, and other structures, such as hair follicles and sweat glands. The dermis is made of two layers of connective tissue that comprise an interconnected mesh of elastin and collagenous fibers, produced by fibroblasts.
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The papillary layer is made of loose, areolar connective tissue, which means the collagen...
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Reticular Dermis01:15

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The papillary and reticular dermis are the two layers of the dermis. They are made of connective tissue with fibers of collagen extending from one to the other, making the border between the two somewhat indistinct. The dermal papillae extending into the epidermis belong to the papillary layer, whereas the dense collagen fiber bundles below belong to the reticular layer.
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Acellular Dermal Matrix: Imaging Features With Histopathology Correlation.

Alysha Dhami1, Cooper D Rutland2, Arash Momeni3

  • 1Breast Imaging Division, Department of Radiology, Stanford University Medical Center, Stanford, CA, USA.

Journal of Breast Imaging
|September 9, 2024
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Summary
This summary is machine-generated.

Acellular dermal matrix (ADM) is a scaffold used in breast reconstruction. Understanding its imaging appearance is key to differentiating it from malignancy and avoiding unnecessary biopsies.

Keywords:
acellular dermal matrixbreast reconstructionfat necrosisimplantmastectomy

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Area of Science:

  • Biomaterials Science
  • Radiology
  • Plastic Surgery

Background:

  • Acellular dermal matrix (ADM) is an acellular, immunologically inert graft derived from cadaveric skin.
  • It serves as a scaffold in reconstructive surgery, particularly in postmastectomy breast reconstruction, to support breast implants and fill defects.
  • ADM offers benefits such as improved cosmetic outcomes and reduced rates of capsular contracture.

Purpose of the Study:

  • To describe the imaging characteristics of Acellular dermal matrix (ADM) on ultrasound, mammography, and MRI.
  • To highlight the importance of clinical context in differentiating ADM from malignancy.
  • To aid radiologists in accurate diagnosis and avoidance of unnecessary biopsies.

Main Methods:

  • Review of imaging findings of ADM on various modalities (Ultrasound, Mammography, Tomosynthesis, MRI).
  • Correlation of imaging findings with intraoperative configuration and histopathological results.
  • Emphasis on clinical knowledge of ADM's use in breast reconstruction.

Main Results:

  • On ultrasound, ADM appears as a subtle band or a palpable oval mass with variable echogenicity.
  • Mammography and tomosynthesis may show ADM as a circumscribed oval mass, potentially with a layered appearance.
  • MRI findings regarding enhancement vary, and histopathology can resemble scar tissue.

Conclusions:

  • Imaging findings of ADM are variable and depend on host tissue incorporation.
  • Familiarity with ADM's appearance and intraoperative use is crucial for accurate diagnosis.
  • Distinguishing ADM from malignancy on imaging can prevent unnecessary interventions.