| Preoperative imaging for DIEA perforator flaps: a comparative study of computed tomographic angiography and doppler ultrasound. | |
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MedLine Citation:
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PMID: 18213740 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Abdominal donor-site flaps, including the transverse rectus abdominis musculocutaneous (TRAM) and deep inferior epigastric artery (DIEA) perforator flaps, are standard in autologous breast reconstruction. With significant variation in the vascular anatomy of the abdominal wall, preoperative imaging is essential for preoperative planning and reducing intraoperative error. Doppler and color duplex sonography have been used with varying results, and the quest continues for optimal preoperative assessment. Computed tomographic angiography has recently been proposed as a noninvasive modality for this purpose. This is the first study to formally compare preoperative Doppler ultrasound with computed tomographic angiography for imaging the DIEA. METHODS: Eight consecutive patients undergoing DIEA perforator flap surgery for breast reconstruction underwent both computed tomographic angiography and Doppler ultrasound preoperatively. All investigations and procedures were performed at the same institution with the same primary and assisting surgeons and the same radiology team. RESULTS: Computed tomographic angiography was superior to Doppler ultrasound at identifying the course of the DIEA and its branching pattern, and in visualizing its perforators. Preoperative computed tomographic angiography was highly specific (100 percent) and more sensitive in mapping and visualizing perforators (p = 0.0078). It was also proficient at identifying the superficial epigastric arterial system and for effectively displaying the results intraoperatively. It was substantially quicker and removed the interobserver error associated with Doppler ultrasonography. The study was ceased after eight patients because of the overwhelming benefit of computed tomographic angiography over Doppler ultrasonography. CONCLUSION: Computed tomographic angiography is a valuable imaging modality for the preoperative assessment of the donor-site vascular supply for TRAM and DIEA perforator flaps. |
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Authors:
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Warren M Rozen; Timothy J Phillips; Mark W Ashton; Damien L Stella; Robert N Gibson; G Ian Taylor |
Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article |
Journal Detail:
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Title: Plastic and reconstructive surgery Volume: 121 ISSN: 1529-4242 ISO Abbreviation: Plast. Reconstr. Surg. Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2008-01-22 Completed Date: 2008-01-29 Revised Date: 2011-02-16 |
Medline Journal Info:
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Nlm Unique ID: 1306050 Medline TA: Plast Reconstr Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1-8 Citation Subset: AIM; IM |
Affiliation:
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Jack Brockhoff Plastic and Reconstructive Surgery Research Unit, University of Melbourne, Parkville, Victoria 3052, Australia. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Cohort Studies Epigastric Arteries / radiography*, transplantation, ultrasonography* Female Humans Mammaplasty / methods* Middle Aged Surgical Flaps / blood supply* Tomography, X-Ray Computed* / instrumentation Ultrasonography, Doppler* / instrumentation |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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