Oncologic Staging Computed Tomography with IV Contrast Has Similar Efficacy to Dedicated Computed Tomography Angiography for Preoperative DIEP Flap Planning.

Autor:	Brown MS; From Summa Health Department of Surgery, Akron, Ohio., Mirhaidari C; Northeast Ohio Medical University (NEOMED), Rootstown, Ohio., Johnson J; Northeast Ohio Medical University (NEOMED), Rootstown, Ohio., Larson BM; From Summa Health Department of Surgery, Akron, Ohio., Cook C; Duke University Medical Center, Durham, N.C., Shue R; Summa Health Department of Radiology, Akron, Ohio., Ventimiglia AJ; Summa Health Department of Radiology, Akron, Ohio., Cody DG; Crystal Clinic Plastic Surgeons, Akron, Ohio.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery. Global open [Plast Reconstr Surg Glob Open] 2024 May 20; Vol. 12 (5), pp. e5709. Date of Electronic Publication: 2024 May 20 (Print Publication: 2024).
DOI:	10.1097/GOX.0000000000005709
Abstrakt:	Background: Due to variations in perforator vasculature, deep inferior epigastric artery perforator (DIEP) flap preoperative imaging can minimize operative time required to locate the most suitable perforators. Dedicated computed tomography angiography (CTA) has been the gold standard; however, many patients have already undergone a staging computed tomography (CT) per oncologic workup. The benefits from CTA may also be realized with a staging CT or CT with IV contrast. Methods: Ten patients who underwent DIEP flap reconstruction with staging CT and CTA within 3 years of one another were included in this study. Reviewers evaluated axial views of both imaging modalities separately to identify each visible perforator in reference to the pubic symphysis from the xiphoid to the pubic symphysis. An intraclass correlation coefficient (ICC) was used to determine agreement in location of perforators between the two imaging studies. Statistical analysis was performed using an ICC and Wilcoxon signed rank-tests. Results: The identified perforators within the patient cohort had an excellent correlation between their location on CT and CTA based upon ICC. The mean number of perforators identified in the CT group was 15.3 (SD 4.9) and in the CTA group was 18.8 (SD 6.4), which was not statistically different ( P = 0.247). Conclusions: CT has similar efficacy in identifying number of perforators and perforator location to dedicated CTA for preoperative planning in DIEP flaps. This has the potential for decreased patient contrast and ionizing radiation exposure as well as improved patient and healthcare resource utilization. Competing Interests: The authors have no financial interest to declare in relation to the content of this article. (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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