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

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.