Papers of The 6th Japan Scar Workshop

5. Analysis of the Physiological Hemodynamics of Anterior Chest Keloids Using MDCT

Takeshi Iimura1, Shimpei Ono1, Hiromitsu Hayashi2, Jyunichi Nakao1,
Teruyuki Dohi1, Satoshi Akaishi1, Hiko Hyakusoku1, Rei Ogawa1
1:Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan
2:Department of Radiology, Nippon Medical School, Tokyo, Japan

Analysis of the physiological hemodynamics of keloids is important to understand the pathophysiology and cause of keloids. Nine anterior chest keloids were analyzed. An angiography of the perforator was performed using MDCT. (1) Distribution of arteries and veins, (2) distribution of the internal mammary artery perforators, and (3) structures of the vessels were analyzed using DICOM viewer Osirix. The results showed a decrease in blood flow inside the keloids, even though blood flow on the surface of the keloids was increased. In general, a dominant perforator of the internal mammary artery was found around the 2nd intercostal space, but dominant perforators were found more laterally and at different positions (especially in the 1st intercostal space) in our huge keloid cases. Moreover, extension of the venous system was strong suggesting that an arteriovenous shunt exists on the keloid surface. It was suggested that these hemodynamic changes in the keloids were caused by the vicariousness of the changes accompanying the ischemia of the keloids and / or the inflammatory changes.
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