Document Detail


Magnetic resonance angiography in preoperative planning of deep inferior epigastric artery perforator flaps.
MedLine Citation:
PMID:  18993122     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Accurate preoperative localisation of deep inferior epigastric artery perforator (DIEaP) provides optimal surgical planning for DIEaP flaps. Cross-sectional imaging by contrast-enhanced magnetic resonance angiography (CE-MRA) has advantages over previously described techniques for perforator imaging including reduced radiation exposure and better muscle to vessel contrast. A retrospective series of 10 unilateral free breast reconstructions following preoperative CE-MRA of the anterior abdominal wall is presented. Mean age of the patients at the time of surgery was 50.3 years (range 44-63 years). An average of 2.8 perforators per study (range 1-5) was identified. Mean perforator luminal diameter was 2.6mm (1.4-4.0mm) with a mean intramuscular course length of 22.3mm (6.4-51.9 mm). Perforator course length was classified as 17% long intramuscular course (>4 cm), 80% short intramuscular course (<4 cm) and 3% paramedian. In all 10 patients, DIEaP flaps were successfully elevated. In all cases the flaps were elevated on vessels identified in preoperative review of the CE-MRA. There was a significant difference in the rates of conversion from DIEaP to transverse rectus abdominis myocutaneous (TRAM) flaps in the group who underwent CE-MRA in comparison to historical controls from the previous year (P=0.025). CE-MRA is an effective tool for DIEaP flap planning.
Authors:
J G Neil-Dwyer; C N Ludman; M Schaverien; S J McCulley; A G B Perks
Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2008-11-06
Journal Detail:
Title:  Journal of plastic, reconstructive & aesthetic surgery : JPRAS     Volume:  62     ISSN:  1878-0539     ISO Abbreviation:  J Plast Reconstr Aesthet Surg     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-16     Completed Date:  2009-12-23     Revised Date:  2010-04-02    
Medline Journal Info:
Nlm Unique ID:  101264239     Medline TA:  J Plast Reconstr Aesthet Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1661-5     Citation Subset:  IM    
Affiliation:
Department of Plastic Surgery, Nottingham City Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK. jneildwy@doctors.org.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Epigastric Arteries / anatomy & histology*
Female
Humans
Magnetic Resonance Angiography / methods
Mammaplasty / methods*
Middle Aged
Preoperative Care / methods*
Retrospective Studies
Surgical Flaps / blood supply*
Tissue and Organ Harvesting / methods
Treatment Outcome
Comments/Corrections
Comment In:
J Plast Reconstr Aesthet Surg. 2010 Jan;63(1):e120-1   [PMID:  19232510 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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