The Value of Preoperative Multidetector Computed Tomography for Deep Inferior Epigastric Artery Perforator Free Flap.

Heo, Chan Yeong; Hong, Ki Yong; Yoon, Chang Jin; Eun, Seok Chan; Baek, Rong Min; Minn, Kyung Won

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2009;36(2):140-146.
Published online March 1, 2009.

The Value of Preoperative Multidetector Computed Tomography for Deep Inferior Epigastric Artery Perforator Free Flap.

Chan Yeong Heo, Ki Yong Hong, Chang Jin Yoon, Seok Chan Eun, Rong Min Baek, Kyung Won Minn

¹Department of Plastic and Reconstructive Surgery, Research Institute of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea. lionheo@snu.ac.kr
²Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
Autologous breast reconstruction with abdominal tissue is one of the best options after mastectomy. In a free transverse rectus abdominis myocutaneous(TRAM) or deep inferior epigastric artery perforator (DIEP) flap, a preoperative evaluation of the precise location of perforating vessels and vascular run-off systems is required. The objective of this report is to demonstrate the usefulness of multidetector computed tomography (MDCT) in the preoperative planning of patients undergoing breast reconstruction with abdominal flap. METHODS: From June 2006 to January 2008, 28 patients underwent MDCT evaluation before breast reconstruction. All subjects were females with an age ranged from 30 to 55 years. The CT scan was performed using a 64-slice MDCT scanner(Brilliance 64; Philips Medical Systems, Best, Netherlands).
RESULTS
One perforator or two major perforators were marked on image in good relation with a hand-held Doppler examination and intraoperative findings. All vascular run-off systems were cleared before operation.
CONCLUSION
Preoperative evaluation of perforator arteries with MDCT angiography is beneficial to the patients undergoing breast reconstruction. This technique provides a noninvasive approach of the vascular anatomy of the entire anterior abdominal wall.

Keywords: Computed X-ray Tomography; Deep inferior epigastric artery perforator flap