Radiology, Vol 162, 157-161, Copyright © 1987 by Radiological Society of North America
Chest wall after mastectomy. Part I. CT appearance of normal postoperative anatomy, postirradiation changes, and optimal scanning techniques
WJ Shea Jr, G de Geer and WR Webb
The computed tomographic (CT) scans of patients with breast carcinoma
treated by surgery with and without radiation therapy were reviewed and
correlated with clinical status. The optimal techniques of patient
examination and the post-therapy findings were analyzed. The brachial
injection of intravenous contrast material produced significant artifacts
that limited interpretation of the ipsilateral chest wall in all cases and
did not give additional information. Scans obtained with the patients' arms
placed at their sides resulted in more clearly interpretable scans,
especially when arm weakness or lymphedema precluded symmetric elevation of
the arms out of the CT gantry. Radiation therapy produced both acute and
chronic changes with characteristic CT appearances. The postoperative
anatomy varied markedly depending on the previous surgery. Careful clinical
correlation with referring physicians was the key to proper scan
evaluation.
