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Abstract
BackgroundThe aim of the study is to compare the efficacy of perforator computed tomographic angiography (P-CTA) and color Doppler ultrasonography (CDUS) in preoperative planning of breast reconstruction with deep inferior epigastric artery perforator (DIEAP) flaps. From October 2018 to August 2019, 42 patients performed breast reconstruction with DIEAP flap procedures. All cases performed CDUS and multidetector perforator CT angiography (P-CTA) within 1 week prior to reconstructive surgery. The CDUS and P-CTA images were interpreted by two experienced vascular radiologists with 8- and 10-year experience, respectively, and compared with the surgical results.ResultsThere were statistically significant differences (P = 0.0025) between CDUS and P-CTA in the detection of the number of perforators with P-CTA being more accurate than CDUS. There were significant differences between the P-CTA and surgical findings in measuring the caliber of dominant perforators (P = 0.002). CDUS was more accurate than P-CTA in this parameter showing sensitivity and specificity of 94 and 96%, respectively. There were significant differences between CDUS and surgical findings in the detection of the course of the intramuscular segment of the perforator (P = 0.0028). P-CTA was more accurate than CDUS in this parameter showing sensitivity and specificity of 96 and 97%, respectively.ConclusionThe pre-operative mapping of perforators by CDUS and P-CTA proved to be effective and complementary to each other in the localization and vascular mapping of deep inferior epigastric artery perforators, thus greatly helping vascular surgeons in performing this surgical procedure.
Highlights
The aim of the study is to compare the efficacy of perforator computed tomographic angiography (P-CTA) and color Doppler ultrasonography (CDUS) in preoperative planning of breast reconstruction with deep inferior epigastric artery perforator (DIEAP) flaps
The objective of this study is to compare the efficacy of perforator computed tomographic angiography (PCTA) and color Doppler ultrasonography (CDUS) in preoperative planning of breast reconstruction with DIEAP flaps
A dominant perforator was detected by CDUS in 41 out of 42 patients and by P-CTA in 42 out of 42 patients
Summary
The aim of the study is to compare the efficacy of perforator computed tomographic angiography (P-CTA) and color Doppler ultrasonography (CDUS) in preoperative planning of breast reconstruction with deep inferior epigastric artery perforator (DIEAP) flaps. From October 2018 to August 2019, 42 patients performed breast reconstruction with DIEAP flap procedures. Breast reconstruction can either be performed with artificial tissue such as saline or silicone implants or by utilizing autologous tissue such as abdominal tissue flaps. The latter yields better results with fewer incidences of complications [2]. The transverse rectus abdominis myocutaneous pedicle flap (TRAM) was the most commonly used autologous breast reconstruction technique in the past 40 years. It presented multiple complications including abdominal wall weakness, asymmetry, and herniation [3]
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