title: Whole-body magnetic resonance angiography for presurgical planning of free-flap head and neck reconstruction.
abstract: OBJECTIVE
  Aim of the study was to evaluate if a whole-body magnetic resonance angiography (MRA) protocol meets the requirements to evaluate the donor and host site target vessels for planning of microvascular head and neck reconstructions.
  
  
  METHODS
  In 20 patients, scheduled for reconstruction of the mandible with fibular free flaps, contrast-enhanced whole-body MRA was performed prior to surgery. 32-Channel 1.5-T MR angiograms were acquired using a 2-step contrast (gadobutrol) injection scheme to visualize the arterial vasculature from head to feet. Maximum intensity projection and multiplanar reconstruction technique was employed to visualize MRA data. For image evaluation the arterial tree was divided into 51 segments. The presence of artefacts impairing diagnostic quality was noted. Evaluable segments were assessed regarding the presence of stenoses >50% diameter reduction, occlusions or aneurysms.
  
  
  RESULTS
  No adverse reactions or complications occurred. Of 1020 vessel segments 1003 (98.3%) were evaluable. 36 stenoses >50%, 50 occlusions and one aneurysm were observed. In 21 of 40 lower limbs relevant atherosclerotic changes were depicted.
  
  
  CONCLUSIONS
  Whole-body MRA proved to be a suitable three-dimensional, noninvasive, nonionising modality for preoperative evaluation of the entire arterial vasculature.
authors.affiliation: Department of Radiology, University of Erlangen-Nuremberg, Maximiliansplatz 1, 91054 Erlangen, Germany. manuel.kramer@uk-erlangen.de
authors.forename: Manuel
authors.initials: M
authors.lastname: Kramer
authors.forename: Emeka
authors.initials: E
authors.lastname: Nkenke
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kikuchi
authors.forename: Siegfried A
authors.initials: SA
authors.lastname: Schwab
authors.forename: Rolf
authors.initials: R
authors.lastname: Janka
authors.forename: Michael
authors.initials: M
authors.lastname: Uder
authors.forename: Michael
authors.initials: M
authors.lastname: Lell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000098:blood supply* / Q000601:surgery*; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013524:Surgical Flaps / Q000098:blood supply* / Q000473:pathology*; D051598:Whole Body Imaging / Q000379:methods*