Planning deep inferior epigastric perforator flaps for breast reconstruction: a comparison between multidetector computed tomography and magnetic resonance angiography.

Objectives: Deep inferior epigastric perforator (DIEP) flaps have become the state of the art in breast reconstruction. We compared the diagnostic performance of multidetector computed tomography (CTA) and magnetic resonance angiography (MRA) in DIEP flap planning.Methods: Twenty-three women (mean a...

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Publicado en:European Radiology Vol. 23; no. 8; pp. 2333 - 2344
Autores principales: Cina, A, Barone-Adesi, L, Rinaldi, P, Cipriani, A, Salgarello, M, Masetti, R, Bonomo, L
Formato: research Journal Article
Publicado: Springer Nature Aug2013
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: Planning deep inferior epigastric perforator flaps for breast reconstruction: a comparison between multidetector computed tomography and magnetic resonance angiography.
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          Cina, A
          Barone-Adesi, L
          Rinaldi, P
          Cipriani, A
          Salgarello, M
          Masetti, R
          Bonomo, L
        affil: Department of Radiological Sciences, Agostino Gemelli Hospital, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168, Rome, Italy, acina@rm.unicatt.it.
      sug:
        subj:
          Breast Neoplasms Radiography
          Magnetic Resonance Angiography Methods
          Breast Reconstruction Methods
          Multidetector Computed Tomography Methods
          Perforator Flap
          Adult
          Aged
          Breast Neoplasms Pathology
          Arteries Pathology
          Arteries Radiography
          Female
          Human
          Middle Age
          Preoperative Care
          Reproducibility of Results
          Adult: 19-44 years
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
      ab: Objectives: Deep inferior epigastric perforator (DIEP) flaps have become the state of the art in breast reconstruction. We compared the diagnostic performance of multidetector computed tomography (CTA) and magnetic resonance angiography (MRA) in DIEP flap planning.Methods: Twenty-three women (mean age 48.0 years, range 26-72 years) underwent preoperative blinded evaluation using 64-slice CTA and 1.5-T MRA. Perforator identification, measurement of their calibre, intramuscular course (IMC), assessment of direct venous connections (DVC) with main superficial veins, superficial venous communications (SVC) between the right and left hemi-abdomen and deep inferior epigastric artery (DIEA) branching type were performed. Surgery was carried out by the same team. Intraoperative findings were the standard of reference.Results: Accuracy in identifying dominant perforators was 91.3 % for both techniques and mean error in calibre measurement 1.18 ± 0.35 mm for CTA and 1.63 ± 0.39 mm for MRA. Accuracy in assessing perforator IMCs was 97.1 % for CTA and 88.4 % for MRA, DVC 94.4 % for both techniques, SVC 91.3 % as well, and DIEA branching type 100 % for CTA and 91.3 % for MRA. Image acquisition and interpretation time was 21 ± 3 min for CTA (35 ± 5 min for MRA).Conclusions: In a strategy to optimise DIEP flap planning avoiding radiation exposure, MRA can be proposed alternatively to CTA.Key Points: • Identification of deep inferior epigastric perforators (DIEP) is important before breast reconstruction. • Both CT and MR angiography are accurate in identifying DIEA perforator branches. • CTA and MRA are equivalent in demonstrating perforator-venous connections. • MRA can be proposed as an alternative to CTA in DIEP planning.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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