Mapping vascolare pre-operatorio con TC multistrato dei rami perforanti dell'arteria epigastrica inferiore in previsione di ricostruzione mammaria post-mastectomia

Translated title of the contribution: Preoperative vascular mapping with multislice CT of deep inferior epigastric artery perforators in planning breast reconstruction after mastectomy

A. Pellegrin, T. Stocca, M. Belgrano, M. Bertolotto, F. Pozzi-Mucelli, Z. Marij Arnež, M. A. Cova

Research output: Contribution to journalArticle

Abstract

Purpose: Our aim was to evaluate the usefulness of computed tomography angiography (CTA) in vascular mapping for planning breast reconstruction after mastectomy using a free flap made with the deep inferior epigastric perforators (DIEP). Materials and methods: We retrospectively evaluated 41 patients, mean age 57 years, scheduled for mastectomy. CTA was performed with a 64-row scanner (Aquilion 64, Toshiba Medical Systems, Japan), with injection of 100 ml of contrast medium (iomeprol 350 mgI/ml, Bracco, Italy) at 4.5 ml/s. Maximum intensity projection (MIP) and threedimensional volume-rendering (VR) reconstructions were made to mark perforator positions. Presentation frequency, anatomy and artery opacification quality were evaluated. Results: DIEP were always depicted (n=81) and subdivided according to Taylor's classification into type I (65%), type II (28%), and type III (7%). We observed a mean of three (range, 1-5) DIEP arteries on the right and two (range, 1-5) on the left side. The superficial inferior epigastric artery (SIEA) was depicted in 6/41 patients, bilaterally in three cases. Opacification was optimal in 30/41 cases, venous contamination due to late arterial phase in eight and low opacification due to early scan in three. Conclusions: Studying DIEP with CTA is useful in the surgical planning of breast reconstruction, even though it requires careful optimisation owing to the critical timing of opacification typical of that vascular district.

Original languageItalian
Pages (from-to)732-743
Number of pages12
JournalRadiologia Medica
Volume118
Issue number5
DOIs
Publication statusPublished - Aug 2013

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Epigastric Arteries
Mammaplasty
Mastectomy
Blood Vessels
Free Tissue Flaps
Contrast Media
Italy
Anatomy
Japan
Arteries
Injections
Computed Tomography Angiography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Mapping vascolare pre-operatorio con TC multistrato dei rami perforanti dell'arteria epigastrica inferiore in previsione di ricostruzione mammaria post-mastectomia. / Pellegrin, A.; Stocca, T.; Belgrano, M.; Bertolotto, M.; Pozzi-Mucelli, F.; Marij Arnež, Z.; Cova, M. A.

In: Radiologia Medica, Vol. 118, No. 5, 08.2013, p. 732-743.

Research output: Contribution to journalArticle

Pellegrin, A. ; Stocca, T. ; Belgrano, M. ; Bertolotto, M. ; Pozzi-Mucelli, F. ; Marij Arnež, Z. ; Cova, M. A. / Mapping vascolare pre-operatorio con TC multistrato dei rami perforanti dell'arteria epigastrica inferiore in previsione di ricostruzione mammaria post-mastectomia. In: Radiologia Medica. 2013 ; Vol. 118, No. 5. pp. 732-743.
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abstract = "Purpose: Our aim was to evaluate the usefulness of computed tomography angiography (CTA) in vascular mapping for planning breast reconstruction after mastectomy using a free flap made with the deep inferior epigastric perforators (DIEP). Materials and methods: We retrospectively evaluated 41 patients, mean age 57 years, scheduled for mastectomy. CTA was performed with a 64-row scanner (Aquilion 64, Toshiba Medical Systems, Japan), with injection of 100 ml of contrast medium (iomeprol 350 mgI/ml, Bracco, Italy) at 4.5 ml/s. Maximum intensity projection (MIP) and threedimensional volume-rendering (VR) reconstructions were made to mark perforator positions. Presentation frequency, anatomy and artery opacification quality were evaluated. Results: DIEP were always depicted (n=81) and subdivided according to Taylor's classification into type I (65{\%}), type II (28{\%}), and type III (7{\%}). We observed a mean of three (range, 1-5) DIEP arteries on the right and two (range, 1-5) on the left side. The superficial inferior epigastric artery (SIEA) was depicted in 6/41 patients, bilaterally in three cases. Opacification was optimal in 30/41 cases, venous contamination due to late arterial phase in eight and low opacification due to early scan in three. Conclusions: Studying DIEP with CTA is useful in the surgical planning of breast reconstruction, even though it requires careful optimisation owing to the critical timing of opacification typical of that vascular district.",
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AU - Pellegrin, A.

AU - Stocca, T.

AU - Belgrano, M.

AU - Bertolotto, M.

AU - Pozzi-Mucelli, F.

AU - Marij Arnež, Z.

AU - Cova, M. A.

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N2 - Purpose: Our aim was to evaluate the usefulness of computed tomography angiography (CTA) in vascular mapping for planning breast reconstruction after mastectomy using a free flap made with the deep inferior epigastric perforators (DIEP). Materials and methods: We retrospectively evaluated 41 patients, mean age 57 years, scheduled for mastectomy. CTA was performed with a 64-row scanner (Aquilion 64, Toshiba Medical Systems, Japan), with injection of 100 ml of contrast medium (iomeprol 350 mgI/ml, Bracco, Italy) at 4.5 ml/s. Maximum intensity projection (MIP) and threedimensional volume-rendering (VR) reconstructions were made to mark perforator positions. Presentation frequency, anatomy and artery opacification quality were evaluated. Results: DIEP were always depicted (n=81) and subdivided according to Taylor's classification into type I (65%), type II (28%), and type III (7%). We observed a mean of three (range, 1-5) DIEP arteries on the right and two (range, 1-5) on the left side. The superficial inferior epigastric artery (SIEA) was depicted in 6/41 patients, bilaterally in three cases. Opacification was optimal in 30/41 cases, venous contamination due to late arterial phase in eight and low opacification due to early scan in three. Conclusions: Studying DIEP with CTA is useful in the surgical planning of breast reconstruction, even though it requires careful optimisation owing to the critical timing of opacification typical of that vascular district.

AB - Purpose: Our aim was to evaluate the usefulness of computed tomography angiography (CTA) in vascular mapping for planning breast reconstruction after mastectomy using a free flap made with the deep inferior epigastric perforators (DIEP). Materials and methods: We retrospectively evaluated 41 patients, mean age 57 years, scheduled for mastectomy. CTA was performed with a 64-row scanner (Aquilion 64, Toshiba Medical Systems, Japan), with injection of 100 ml of contrast medium (iomeprol 350 mgI/ml, Bracco, Italy) at 4.5 ml/s. Maximum intensity projection (MIP) and threedimensional volume-rendering (VR) reconstructions were made to mark perforator positions. Presentation frequency, anatomy and artery opacification quality were evaluated. Results: DIEP were always depicted (n=81) and subdivided according to Taylor's classification into type I (65%), type II (28%), and type III (7%). We observed a mean of three (range, 1-5) DIEP arteries on the right and two (range, 1-5) on the left side. The superficial inferior epigastric artery (SIEA) was depicted in 6/41 patients, bilaterally in three cases. Opacification was optimal in 30/41 cases, venous contamination due to late arterial phase in eight and low opacification due to early scan in three. Conclusions: Studying DIEP with CTA is useful in the surgical planning of breast reconstruction, even though it requires careful optimisation owing to the critical timing of opacification typical of that vascular district.

KW - Breast reconstruction

KW - Computed tomography angiography

KW - Deep inferior epigastric artery perforator

KW - Mastectomy

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