| Contrast-enhanced magnetic resonance angiography for preoperative imaging in DIEP flap breast reconstruction. | |
| | |
MedLine Citation:
|
PMID: 21701321 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Contrast-enhanced magnetic resonance angiography has been shown to be very accurate for identifying the perforator size, location, and intramuscular course, and the associated venous system, without exposing the patient to ionizing radiation. This study reports the authors' experience using this imaging modality in a large patient series. METHODS: A retrospective review of patients who had undergone preoperative contrast-enhanced magnetic resonance angiography followed by free abdominal flap breast reconstruction was conducted. The results of imaging were compared with intraoperative findings, and surgical outcomes were compared with scan data. The results were compared with control data in patients who did not undergo presurgical imaging. RESULTS: One hundred thirty-two patients underwent contrast-enhanced magnetic resonance angiography presurgical imaging, and the results were compared with 84 controls. The imaging was found to be accurate for evaluating the perforator anatomy for free abdominal flap planning, with a high concordance between imaging and intraoperative findings. Without presurgical angiography, the ratio of deep inferior epigastric perforator (DIEP) flap-to-free transverse rectus abdominis musculocutaneous flap harvest was 0.9:1; with presurgical imaging, the ratio was 1.6:1 (p < 0.05). With presurgical angiography, there was a mean reduction in operating time of 26 minutes for unilateral DIEP flap harvest and 40 minutes for bilateral harvest, although these values were not significant. There was a significant reduction in the partial flap failure rate with preoperative imaging. CONCLUSIONS: Presurgical imaging using contrast-enhanced magnetic resonance angiography demonstrates a high concordance with intraoperative findings. In this series, the percentage of flaps that were raised as DIEP flaps was significantly increased in patients who underwent preoperative imaging, and the partial flap failure rate was significantly reduced. CLINICAL QUESTION/LEVEL OF EVIDENCE: : Therapeutic, III.(Figure is included in full-text article.). |
| | |
Authors:
|
Mark V Schaverien; Catherine N Ludman; Jason Neil-Dwyer; Graeme B Perks; Nadeem Akhtar; Jeremy N Rodrigues; Konstantinos Benetatos; Anna Raurell; Tuabin Rasheed; Stephen J McCulley |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Plastic and reconstructive surgery Volume: 128 ISSN: 1529-4242 ISO Abbreviation: Plast. Reconstr. Surg. Publication Date: 2011 Jul |
Date Detail:
|
Created Date: 2011-06-24 Completed Date: 2011-08-30 Revised Date: 2012-09-10 |
Medline Journal Info:
|
Nlm Unique ID: 1306050 Medline TA: Plast Reconstr Surg Country: United States |
Other Details:
|
Languages: eng Pagination: 56-62 Citation Subset: AIM; IM |
Affiliation:
|
Department of Plastic Surgery and Radiology, Nottingham University Hospitals NHS Trust, Nottingham NG5 1PB, United Kingdom. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Angiography / methods* Case-Control Studies Contrast Media* Female Humans Magnetic Resonance Angiography* / methods Mammaplasty / methods* Middle Aged Preoperative Care Retrospective Studies Surgical Flaps / blood supply* Young Adult |
| Chemical | |
Reg. No./Substance:
|
0/Contrast Media |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Ultrasound-guided bilateral transversus abdominis plane block for postoperative analgesia after brea...
Next Document: An analysis of 277 consecutive latissimus dorsi breast reconstructions: a focus on capsular contract...