title: Magnetic resonance angiography for free fibula flap transfer.
abstract: Recent refinements of magnetic resonance angiography (MRA) allow imaging vessels as small as the septocutaneous perforators (< or = 1 to 2 mm diameter), but a Medline review reveals no report of septocutaneous vessel imaging for free flap surgery. Challenges in fibula free flap preparation include knowledge of: (1) tibioperoneal anatomy, (2) the positions of the perforator vessels on the peroneal artery and their course in the posterolateral intermuscular septum, and (3) the cutaneous distribution of the perforators. Questioning whether high-resolution MRA could image these, we studied the lower extremities of nine healthy volunteers. MRA demonstrated tibioperoneal anatomy in sufficient detail to exclude anatomic variants and significant peripheral vascular disease and showed septocutaneous perforators arising from the peroneal artery and coursing in the posterolateral intermuscular septum to the skin. High-resolution MRA provided anatomic and clinical information that conventionally has been impossible to obtain preoperatively or has required multiple tests, often of an invasive nature.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Eri
authors.initials: E
authors.lastname: Fukaya
authors.forename: Richard F
authors.initials: RF
authors.lastname: Grossman
authors.forename: David
authors.initials: D
authors.lastname: Saloner
authors.forename: Pablo
authors.initials: P
authors.lastname: Leon
authors.forename: Motohiro
authors.initials: M
authors.lastname: Nozaki
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Mathes
mesh_terms: D000328:Adult; D005260:Female; D005360:Fibula / Q000098:blood supply; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D013524:Surgical Flaps / Q000098:blood supply*