Preliminary evaluation of the deep inferior epigastric artery perforator with CT angiography / 中华放射学杂志

ABSTRACT

Objective To evaluate the clinical value of multislice-CT angiography (MSCTA)in planning for the patients undergoing deep inferior epigastric artery perforator (DIEAP) flap operations. Methods Eighteen patients were performed with a 16-slice CT scanner to evaluate the deep inferior epigastric artery perforator prior to DIEAP flap operations. Axial, multiplanar reconstruction( MPR), maximum intensity projection(MIP) and volume rendered (VR) images were analysed and the origins, calibers, courses and anatomic relationships of the deep inferior epigastric artery perforator were evaluated. The anastomosis between the superficial inferior epigastric artery and the main perforator was observed as well. The images were classified into three grades based on the vessels'appearance. A + indicated the vessel appeared clear,continuous and thick. A- indicated the vessel appeared foggy,discontinuous and thin or the vessel partly showed. B indicated no related vessel can be seen. Other 18 patients undergoing conventional abdomen-pelvis CT scans for other reasons were used for control group to compare their CT findings of the deep inferior epigastric artery perforator. Results MSCTA well showed the course of the deep inferior epigastric artery (DIEA). Of the 18 cases, 17 cases appeared as A +, another one A -. It precisely displayed the origins, subcutaneous and intramuscular courses, relations of the main perforators on all cases of showing A +. The exact points where the chosen perforator vessels emerged from the rectus abdominis muscle fascia were located precisely. The superficial inferior epigastric arteries were mostly displayed and the connection between the arteries and the largest-caliber perforator from the deep system could also be shown clearly. Strict concordance with operative findings was found in CTA. Conclusion MSCTA can precisely locate the chosen perforator vessels emerging from the rectus abdominis muscle fascia and it may be a feasible, fast, safe and effective method for preoperative evaluation of DIEAP.