Power Doppler imaging in preoperative planning and postoperative monitoring of muscle flaps.
OBJECTIVE
We assessed the utility of power Doppler imaging (PDI) in preoperative planning and postoperative evaluation of microvascular tissue transfers.


METHODS
Twenty-five PDI studies were performed on 23 patients using a 5-10-MHz linear-array transducer. Thirteen patients were assessed preoperatively for patency of the desired donor vessel; 8 of them had surgical scars overlying the desired vascular territory. Twelve patients (including 2 from the first group) were evaluated postoperatively for patency of the vascular anastomoses and adequacy of the blood supply to the transferred tissue.


RESULTS
Twelve of the 13 patients assessed preoperatively had successful flap transfers. Four of the 8 patients with scars over the desired vascular territories had absent or aberrant arteries, necessitating a change in the operative plan. None of these patients had operative complications. Eight of the 12 patients scanned postoperatively had patent anastomoses. In 2 of these patients, impending surgery was averted when the adequacy of the tissue blood supply was established with PDI. In 4 patients, PDI showed arterial or venous compromise, which was confirmed at surgery.


CONCLUSIONS
PDI is a useful technique in microsurgical tissue transfer for assessing the patency of desired donor vessels preoperatively and for postoperative evaluation of blood supply.
Loh
N
N
Department of Radiology, Stanford University Medical Center, California 94305, USA.
Ch'en
I Y
IY
Olcott
E
E
Jeffrey
R B
RB
Hui
K C
KC
Persons
B
B
Lineaweaver
W C
WC
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D002921:Cicatrix / Q000601:surgery; D019074:Epigastric Arteries / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011182:Postoperative Care / Q000379:methods*; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods; D017568:Rectus Abdominis / Q000098:blood supply / Q000601:surgery; D013524:Surgical Flaps / Q000098:blood supply*; D018608:Ultrasonography, Doppler