title: Three-dimensional contrast-enhanced magnetic resonance angiography for anterolateral thigh flap outlining: A retrospective case series of 68 patients.
abstract: Flap transfer is increasingly used for repairing limb defects secondary to trauma or tumor, and appropriate preoperative planning plays a critical role. The present study aimed to examine the use of three-dimensional (3D) contrast-enhanced magnetic resonance angiography (CE-MRA) in evaluating the blood supply distribution and perforating branch pattern of anterolateral thigh (ALT) flaps. Bilateral donor lower limbs were scanned in 68 patients (136 limbs) using a Siemens Avanto 1.5 T magnetic resonance imaging scanner with a 3D fast low-angle shot sequence, following the thin-slab maximum intensity projection (TS-MIP) technique. The lateral femoral circumflex artery (LFCA) was visualized in all patients: 101 limbs (101/136, 74.3%) were type I; 20 limbs (20/136, 14.7%) were type II; 3 limbs (3/136, 2.2%) were type III; and 12 limbs (12/136, 8.8%) were type IV. Tertiary branches were identified in 94 limbs (94/136, 69.1%). Donor flaps were outlined according to MRA TS-MIP findings in 4 patients. All flaps survived uneventfully following the transfer. In donor flap outlining, 3D CE-MRA with the TS-MIP technique allowed an accurate, direct visualization of the branching pattern and distribution profile of the LFCA supplying the ALT flap.
authors.affiliation: Department of Radiology, Jinhua Municipal Central Hospital, Jinhua, Zhejiang 321000, P.R. China.
authors.forename: Chunjing
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Department of Hand-Foot Surgery, Jinhua Municipal Central Hospital, Jinhua, Zhejiang 321000, P.R. China.
authors.forename: Ping
authors.initials: P
authors.lastname: Lin
authors.affiliation: Department of Medical Sciences, Jinhua College of Profession and Technology, Jinhua, Zhejiang 321007, P.R. China.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Fu
authors.affiliation: Department of Radiology, Jinhua Municipal Central Hospital, Jinhua, Zhejiang 321000, P.R. China.
authors.forename: Jiner
authors.initials: J
authors.lastname: Shu
authors.affiliation: Department of Radiology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, P.R. China.
authors.forename: Huimin
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Hand-Foot Surgery, Jinhua Municipal Central Hospital, Jinhua, Zhejiang 321000, P.R. China.
authors.forename: Xiaogang
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Radiology, Jinhua Municipal Central Hospital, Jinhua, Zhejiang 321000, P.R. China.
authors.forename: Jianrong
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Medical Sciences, Jinhua College of Profession and Technology, Jinhua, Zhejiang 321007, P.R. China.
authors.forename: Mingxing
authors.initials: M
authors.lastname: Ding
keywords: contrast-enhanced; flap; lateral femoral circumflex artery; magnetic resonance angiography; three-dimensional reconstruction