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The accuracy of computed tomographic angiography for mapping the perforators of the deep inferior epigastric artery: a blinded, prospective cohort study.

Abstract：

BACKGROUND:The deep inferior epigastric artery perforator flap is increasingly used for autologous breast reconstruction, with low donor-site morbidity cited as a major advantage of this operation. Preoperative imaging of the donor-site vasculature is frequently used as a further means of improving operative outcome. Computed tomographic angiography has been increasingly described as a preferred imaging modality; however, its formal evaluation has not been described in a clinical setting. METHODS:A prospective, single-blind, cohort study was undertaken on 60 consecutive patients for whom deep inferior epigastric artery perforator flap surgery had been planned. Patients who did not undergo the procedure during the study period were excluded, with 42 patients ultimately included in the study. All computed tomographic angiography scans were obtained at a single institution. Perforators were mapped both on angiography and intraoperatively using a grid of 4-mm squares centered on the umbilicus. Only perforators larger than 1 mm were included in the study. All imaging findings were recorded by a single operator, and all intraoperative findings were recorded by the operating surgeon. RESULTS:Computed tomographic angiography identified 280 major perforators in 42 patients. It was highly accurate, demonstrating 279 perforators recorded accurately, with one false-positive and one false-negative. Its sensitivity for mapping perforators was thus 99.6 percent, with a positive predictive value of 99.6 percent. CONCLUSIONS:Computed tomographic angiography is highly accurate in identifying and mapping the perforators of the deep inferior epigastric artery. Its accuracy is superior to that of the previous modalities used in this role and suggests the usefulness of this technique before deep inferior epigastric artery perforator flap surgery for breast reconstruction.

journal_name

Plast Reconstr Surg

journal_title

Plastic and reconstructive surgery

authors

Rozen WM,Ashton MW,Stella DL,Phillips TJ,Grinsell D,Taylor GI

doi

10.1097/PRS.0b013e3181845994

subject

Has Abstract

pub_date

2008-10-01 00:00:00

pages

1003-1009

issue

eissn

0032-1052

issn

1529-4242

pii

00006534-200810000-00001

journal_volume

122

pub_type

临床试验,杂志文章

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The accuracy of computed tomographic angiography for mapping the perforators of the deep inferior epigastric artery: a blinded, prospective cohort study.