Conventional CT versus Dedicated CT Angiography in DIEP Flap Planning: A Feasibility Study
| Autor: | Giuseppe Visconti, Sara Mercogliano, Paolo Belli, Marzia Salgarello, Giulia Macrì, Alessandro Cina, Anna D’Angelo, Liliana Barone Adesi, Elena Jane Mason, Gianluca Franceschini, Pierluigi Barbieri, Sabatino D'Archi, Riccardo Manfredi, Cristina Grippo |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Settore MED/18 - CHIRURGIA GENERALE medicine.medical_treatment lcsh:Medicine Medicine (miscellaneous) Article Superficial inferior epigastric artery 030218 nuclear medicine & medical imaging 03 medical and health sciences breast cancer 0302 clinical medicine Breast cancer DIEP flap medicine medicine.diagnostic_test business.industry lcsh:R Deep Inferior Epigastric Artery conventional CT and CT angiography medicine.disease DIEP flap planning Inferior epigastric vein medicine.vein 030220 oncology & carcinogenesis Angiography Radiology Breast reconstruction business Mastectomy |
| Zdroj: | Journal of Personalized Medicine Volume 11 Issue 4 Journal of Personalized Medicine, Vol 11, Iss 277, p 277 (2021) |
| ISSN: | 2075-4426 |
| DOI: | 10.3390/jpm11040277 |
| Popis: | The deep inferior epigastric perforator (DIEP) flap is used with increasing frequency in post-mastectomy breast reconstruction. Preoperative mapping with CT angiography (CTa) is crucial in reducing surgical complications and optimizing surgical techniques. Our study’s goal was to investigate the accuracy of conventional CT (cCT), performed during disease staging, compared to CTa in preoperative DIEP flap planning. In this retrospective, single-center study, we enrolled patients scheduled for mastectomy and DIEP flap breast reconstruction, subjected to cCT within 24 months after CTa. We included 35 patients in the study. cCT accuracy was 95% (CI 0.80–0.98) in assessing the three largest perforators, 100% (CI 0.89–100) in assessing the dominant perforator, 93% (CI 0.71–0.94) in assessing the perforator intramuscular course, and 90.6% (CI 0.79–0.98) in assessing superficial venous communications. Superficial inferior epigastric artery (SIEA) caliber was recognized in 90% of cases (CI 0.84–0.99), with an excellent assessment of superficial inferior epigastric vein (SIEV) integrity (96% of cases, CI 0.84–0.99), and a lower accuracy in the evaluation of deep inferior epigastric artery (DIEA) branching type (85% of cases, CI 0.69–0.93). The mean X-ray dose spared would have been 788 ± 255 mGy/cm. Our study shows that cCT is as accurate as CTa in DIEP flap surgery planning. |
| Databáze: | OpenAIRE |
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