Color Doppler Ultrasound versus Computed Tomography Angiography for Preoperative Anterolateral Thigh Flap Perforator Imaging: A Systematic Review and Meta-Analysis.

Autor:	Moore R; College of Medicine, Medical University of South Carolina, Charleston, South Carolina., Mullner D; Division of Plastic and Reconstructive Surgery, Medical University of South Carolina, Charleston, South Carolina., Nichols G; Division of Plastic and Reconstructive Surgery, Medical University of South Carolina, Charleston, South Carolina., Scomacao I; College of Medicine, Medical University of South Carolina, Charleston, South Carolina.; Division of Plastic and Reconstructive Surgery, Medical University of South Carolina, Charleston, South Carolina., Herrera F; College of Medicine, Medical University of South Carolina, Charleston, South Carolina.; Division of Plastic and Reconstructive Surgery, Medical University of South Carolina, Charleston, South Carolina.
Jazyk:	angličtina
Zdroj:	Journal of reconstructive microsurgery [J Reconstr Microsurg] 2022 Sep; Vol. 38 (7), pp. 563-570. Date of Electronic Publication: 2021 Dec 27.
DOI:	10.1055/s-0041-1740958
Abstrakt:	Background:  The anterolateral thigh (ALT) perforator flap is a commonly used flap with a predictable, though often variable, perforator anatomy. Preoperative imaging with color Doppler ultrasound (CDU) and computed tomography angiography (CTA) of ALT flap perforators can be a useful tool for flap planning. This study provides a complete review and analysis of the relevant preoperative ALT imaging literature. Methods:  Studies related to preoperative CDU and CTA imaging were reviewed, and information related to imaging method, sensitivity, false-positive rates, and perforator course identification (musculocutaneous vs. septocutaneous) were analyzed. Results:  A total of 23 studies related to preoperative ALT flap CDU and CTA imaging were included for review and analysis. Intraoperative perforator identification was compared with those found preoperatively using CDU ( n  = 672) and CTA ( n  = 531). Perforator identification sensitivity for CDU was 95.3% (95% CI: 90.9-97.6%) compared with the CTA sensitivity of 90.4% (95% confidence interval [CI]: 74.4-96.9%). The false-positive rate for CDU was 2.8% (95% CI: 1.1-4.5%) compared with 2.4% (95% CI: 0.7-4.1%) for CTA. Accuracy of perforator course identification was 95.5% (95% CI: 93.6-99.2%) for CDU and 96.9% (95% CI: 92.7-100.1%) for CTA. Conclusion:  CDU provides the reconstructive surgeon with greater preoperative perforator imaging sensitivity compared with CTA; however, false-positive rates are marginally higher with preoperative CDU. Preoperative imaging for ALT flap design is an effective tool, and the reconstructive surgeon should consider the data presented here when selecting a flap imaging modality. Competing Interests: None declared. (Thieme. All rights reserved.)
Databáze:	MEDLINE
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