ABSTRACT
<p><b>OBJECTIVE</b>To explore the vascular structure of the deep inferior epigastric artery perforator with the four-dimensional computed tomography (CT) angiography.</p><p><b>METHODS</b>10 abdominal specimens harvested from fresh cadavers were cannulated with trocar and injected with contrast medium in the deep inferior epigastric artery at different levels, including the deep inferior epigastric artery, its bifurcations, the lateral or medial large perforators. During the perfusion of the contrast medium in the flap, the flap was scanned by three-dimensional CT (four-dimensional defined as three dimensional CT plus time). The CT data were sent to CT workstation and the images were processed and reformatted.</p><p><b>RESULTS</b>The deep inferior epigastric artery perforator terminates in the subdermal vascular plexus, with bifurcating superior to the Scarpa fascia and under the skin. The anastomosis in the abdominal midline occurs in the subdermal vascular plexus. The blood flow distributes in two ways, one is the subdermal vascular plexus, the other is the existed vascular structure. The zone overlying the rectus muscle in the pedicle side has the best blood supply, the other adjacent zone on the ipsilateral side of the abdomen, the zone overlying the contralateral rectus muscle and the zone lateral to the contralateral rectus muscle has declining perfusion.</p><p><b>CONCLUSIONS</b>The four-dimensional CT is a useful method to study the vascular structure of the deep inferior epigastric artery perforator in the superficial fascia.</p>