Vascular mapping of head and neck: computed tomography angiography versus digital subtraction angiography.
OBJECTIVE
The aim of the study was to compare multislice computed tomography angiography (MSCTA) to digital subtraction angiography (DSA) for vascular mapping of the head and neck.


METHODS
In 50 patients who were scheduled for microvascular reconstruction of the mandible with osteomyocutaneous flaps, MSCTA was carried out before surgery. DSA served as the method of reference. Selective common carotid angiograms were acquired in 2 projections for both sides of the neck. A 64-slice spiral computed tomography (CT) was carried out with a dual-phase protocol, using the arterial phase images for 3-dimensional CTA reconstruction. Volume rendering was used to visualize MSCTA data.


RESULTS
No adverse reactions or complications occurred during or after the procedures. All CT angiograms were of diagnostic quality. No statistically significant differences between MSCTA and DSA were found for the detection of branches of the external carotid artery that are relevant host vessels for microsurgery neither in the group of 26 patients who had not had surgical treatment before (P = .687), nor in the group of 24 patients who were affected by either a tumor recurrence or an infected osteoradionecrosis (P = .508).


CONCLUSIONS
MSCTA proved to be a reliable alternative to DSA in vascular mapping for planning of microvascular reconstruction of the mandible.
Kramer
Manuel
M
Institute of Diagnostic Radiology, University of Erlangen-Nuremberg, Erlangen, Germany. manuel.kramer@uk-erlangen.de
Vairaktaris
Eleftherios
E
Nkenke
Emeka
E
Schlegel
Karl Andreas
KA
Neukam
Friedrich Wilhelm
FW
Lell
Michael
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000098:blood supply / Q000000981:diagnostic imaging / Q000628:therapy; D002342:Carotid Artery, External / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D005260:Female; D006257:Head / Q000098:blood supply* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008334:Mandible / Q000098:blood supply / Q000601:surgery; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000628:therapy; D009333:Neck / Q000098:blood supply* / Q000000981:diagnostic imaging; D009364:Neoplasm Recurrence, Local / Q000098:blood supply / Q000532:radiotherapy / Q000601:surgery; D010025:Osteoradionecrosis / Q000000981:diagnostic imaging / Q000628:therapy; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*