The Anatomical Study of Internal Mammary Vessels Using Sonography and 2-Dimensional Computed Tomography

Han, Sang Hoon; Yoon, Sang Yup; Park, Jeong Mi

Abstract

The aim of the present study is to get anatomical information of internal mammary vessels(IMV), which is usually used for recipient vessels in the breast reconstruction. The past anatomical studies of these vessels had been done primarily with cadavers in the Occidentals. Because there is no report for the anatomical study of these vessels and also the cadaver study is pretty limited in this country, we studied the anatomical pattern of IMV in Koreans by using two dimensional reconstructive computed tomography (2DCT) and Doppler ultrasound (US). The branching patterns, level of bifurcation, size of IMV and the distance from the sternal edge to the IMV were measured. This study was performed in 30 breast cancer patients from May 1999 to May 2000. One artery and one vein on both sides(type I) was the most common type that were observed in 22 of 30 patients(73%). The diameter of the internal mammary artery(average 2.1 mm) was constant but that of the internal mammary vein had a wide variation(ranged 0.8 to 4.8 mm). The distance from sternum to IMV gradually got narrower as it went caudally. In three cases the size of vein was not enough for anastomosis, but the bifurcation point may be used for anastomosis due to the wider point. Compared with the result of Caucasian, the incidence of bifurcation of internal mammary vein was lower and the level of bifurcation was higher. The result showed that the most successful level of anastomosis was the 3rd intercostal space in Korean due to shorter chest. The combination of 2DCT and US provided us with useful preoperative information as well as general anatomical data in Korean.