MDCT in the preoperative planning of abdominal perforator surgery for postmastectomy breast reconstruction.
OBJECTIVE
This study aimed to evaluate the utility of MDCT in planning abdominal perforator surgery for breast reconstruction in patients who have undergone mastectomy.


METHODS
One hundred twenty-six consecutive patients scheduled for postmastectomy breast reconstruction using deep inferior epigastric perforator flaps underwent MDCT. The images were evaluated to identify, characterize, and map the dominant musculocutaneous perforator vessels of the deep inferior epigastric artery. In the first 36 patients, we compared the intraoperative findings with the preoperative MDCT findings. In the latter 90 patients, the dominant perforator vessels were directly selected on the basis of MDCT findings.


RESULTS
We found an exact correlation between the intraoperative and radiologic findings in the first 36 cases. In the following 90 cases, the average operating time saved per patient was 1 hour 40 minutes and there was a significant reduction in postsurgical complications. The preoperative evaluation by MDCT confirmed the wide range of variability in the vascular anatomy of the abdominal wall previously described in anatomic studies.


CONCLUSIONS
MDCT provides valuable information before surgery about the arterial anatomy of the inferior abdominal wall. It enables accurate identification of the most suitable dominant perforator vessel and makes surgical perforator flap procedures for breast reconstruction faster and safer.
Clavero
Juan A
JA
Department of Radiology, Creu-Blanca, C/Corcega 345, 08037 Barcelona, Spain. jaclavero@creu-blanca.es
Masia
Jaume
J
Larrañaga
Jose
J
Monill
Josep M
JM
Pons
Gemma
G
Siurana
Sahyly
S
Alomar
Xavier
X
D000009:Abdominal Muscles / Q000000981:diagnostic imaging* / Q000637:transplantation*; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008408:Mastectomy / Q000295:instrumentation* / Q000379:methods; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods*; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome