PR11PREOPERATIVE IMAGING FOR DIEA PERFORATOR FLAPS: A COMPARATIVE STUDY OF CT ANGIOGRAPHY AND DOPPLER ULTRASOUND
Identifieur interne : 007547 ( Istex/Corpus ); précédent : 007546; suivant : 007548PR11PREOPERATIVE IMAGING FOR DIEA PERFORATOR FLAPS: A COMPARATIVE STUDY OF CT ANGIOGRAPHY AND DOPPLER ULTRASOUND
Auteurs : W. M. Rozen ; T. J. Phillips ; M. W. Ashton ; D. L. Stella ; R. N. Gibson ; G. I. TaylorSource :
- ANZ Journal of Surgery [ 1445-1433 ] ; 2007-05.
Abstract
Background Abdominal donor site flaps, including the Transverse Rectus Abdominis Musculocutaneous (TRAM) and Deep Inferior Epigastric Artery (DIEA) perforator flaps, are the standard in autologous breast reconstruction. With variation in the vascular anatomy of the abdominal wall, preoperative imaging is essential for preoperative planning and reducing intraoperative error. Ultrasound has been used previously with varying results, and the quest continues for optimal preoperative assessment. Computerised Tomography Angiography (CTA) has been recently proposed as a non‐invasive modality for this purpose. This is the first study to formally compare preoperative Doppler ultrasound with CTA for imaging the DIEA.
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DOI: 10.1111/j.1445-2197.2007.04127_11.x
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">PR11PREOPERATIVE IMAGING FOR DIEA PERFORATOR FLAPS: A COMPARATIVE STUDY OF CT ANGIOGRAPHY AND DOPPLER ULTRASOUND</title><author><name sortKey="Rozen, W M" sort="Rozen, W M" uniqKey="Rozen W" first="W. M." last="Rozen">W. M. Rozen</name><affiliation><mods:affiliation>Royal Melbourne Hospital, Victoria, Australia</mods:affiliation></affiliation></author><author><name sortKey="Phillips, T J" sort="Phillips, T J" uniqKey="Phillips T" first="T. J." last="Phillips">T. J. Phillips</name><affiliation><mods:affiliation>Royal Melbourne Hospital, Victoria, Australia</mods:affiliation></affiliation></author><author><name sortKey="Ashton, M W" sort="Ashton, M W" uniqKey="Ashton M" first="M. W." last="Ashton">M. W. Ashton</name><affiliation><mods:affiliation>Royal Melbourne Hospital, Victoria, Australia</mods:affiliation></affiliation></author><author><name sortKey="Stella, D L" sort="Stella, D L" uniqKey="Stella D" first="D. L." last="Stella">D. L. Stella</name><affiliation><mods:affiliation>Royal Melbourne Hospital, Victoria, Australia</mods:affiliation></affiliation></author><author><name sortKey="Gibson, R N" sort="Gibson, R N" uniqKey="Gibson R" first="R. N." last="Gibson">R. N. Gibson</name><affiliation><mods:affiliation>Royal Melbourne Hospital, Victoria, Australia</mods:affiliation></affiliation></author><author><name sortKey="Taylor, G I" sort="Taylor, G I" uniqKey="Taylor G" first="G. I." last="Taylor">G. I. Taylor</name><affiliation><mods:affiliation>Royal Melbourne Hospital, Victoria, Australia</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:FA0A884ABE135AC61929BEDCB011F2932425752F</idno><date when="2007" year="2007">2007</date><idno type="doi">10.1111/j.1445-2197.2007.04127_11.x</idno><idno type="url">https://api.istex.fr/document/FA0A884ABE135AC61929BEDCB011F2932425752F/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">007547</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">007547</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main">PR11
PREOPERATIVE IMAGING FOR DIEA PERFORATOR FLAPS: A COMPARATIVE STUDY OF CT ANGIOGRAPHY AND DOPPLER ULTRASOUND</title><author><name sortKey="Rozen, W M" sort="Rozen, W M" uniqKey="Rozen W" first="W. M." last="Rozen">W. M. Rozen</name><affiliation><mods:affiliation>Royal Melbourne Hospital, Victoria, Australia</mods:affiliation></affiliation></author><author><name sortKey="Phillips, T J" sort="Phillips, T J" uniqKey="Phillips T" first="T. J." last="Phillips">T. J. Phillips</name><affiliation><mods:affiliation>Royal Melbourne Hospital, Victoria, Australia</mods:affiliation></affiliation></author><author><name sortKey="Ashton, M W" sort="Ashton, M W" uniqKey="Ashton M" first="M. W." last="Ashton">M. W. Ashton</name><affiliation><mods:affiliation>Royal Melbourne Hospital, Victoria, Australia</mods:affiliation></affiliation></author><author><name sortKey="Stella, D L" sort="Stella, D L" uniqKey="Stella D" first="D. L." last="Stella">D. L. Stella</name><affiliation><mods:affiliation>Royal Melbourne Hospital, Victoria, Australia</mods:affiliation></affiliation></author><author><name sortKey="Gibson, R N" sort="Gibson, R N" uniqKey="Gibson R" first="R. N." last="Gibson">R. N. Gibson</name><affiliation><mods:affiliation>Royal Melbourne Hospital, Victoria, Australia</mods:affiliation></affiliation></author><author><name sortKey="Taylor, G I" sort="Taylor, G I" uniqKey="Taylor G" first="G. I." last="Taylor">G. I. Taylor</name><affiliation><mods:affiliation>Royal Melbourne Hospital, Victoria, Australia</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">ANZ Journal of Surgery</title><title level="j" type="alt">ANZ JOURNAL SURGERY</title><idno type="ISSN">1445-1433</idno><idno type="eISSN">1445-2197</idno><imprint><biblScope unit="vol">77</biblScope><biblScope unit="page" from="A64">A64</biblScope><biblScope unit="page" to="A64">A64</biblScope><biblScope unit="page-count">1</biblScope><publisher>Blackwell Publishing Asia</publisher><pubPlace>Melbourne, Australia</pubPlace><date type="published" when="2007-05">2007-05</date></imprint><idno type="ISSN">1445-1433</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1445-1433</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Background Abdominal donor site flaps, including the Transverse Rectus Abdominis Musculocutaneous (TRAM) and Deep Inferior Epigastric Artery (DIEA) perforator flaps, are the standard in autologous breast reconstruction. With variation in the vascular anatomy of the abdominal wall, preoperative imaging is essential for preoperative planning and reducing intraoperative error. Ultrasound has been used previously with varying results, and the quest continues for optimal preoperative assessment. Computerised Tomography Angiography (CTA) has been recently proposed as a non‐invasive modality for this purpose. 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PREOPERATIVE IMAGING FOR DIEA PERFORATOR FLAPS: A COMPARATIVE STUDY OF CT ANGIOGRAPHY AND DOPPLER ULTRASOUND</title></titleStmt><publicationStmt><publisher>Blackwell Publishing Asia</publisher><pubPlace>Melbourne, Australia</pubPlace><date type="published" when="2007-05"></date></publicationStmt><notesStmt><note type="content-type" subtype="abstract" source="abstract" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-HPN7T1Q2-R">abstract</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="abstract"><analytic><title level="a" type="main">PR11
PREOPERATIVE IMAGING FOR DIEA PERFORATOR FLAPS: A COMPARATIVE STUDY OF CT ANGIOGRAPHY AND DOPPLER ULTRASOUND</title><title level="a" type="short">ANZ J. Surg. 2007; 77 (Suppl. 1)</title><author xml:id="author-0000"><persName><forename type="first">W. M.</forename><surname>Rozen</surname></persName><affiliation>Royal Melbourne Hospital, Victoria, Australia<address><country key="AU"></country></address></affiliation></author><author xml:id="author-0001"><persName><forename type="first">T. J.</forename><surname>Phillips</surname></persName><affiliation>Royal Melbourne Hospital, Victoria, Australia<address><country key="AU"></country></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">M. W.</forename><surname>Ashton</surname></persName><affiliation>Royal Melbourne Hospital, Victoria, Australia<address><country key="AU"></country></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">D. L.</forename><surname>Stella</surname></persName><affiliation>Royal Melbourne Hospital, Victoria, Australia<address><country key="AU"></country></address></affiliation></author><author xml:id="author-0004"><persName><forename type="first">R. N.</forename><surname>Gibson</surname></persName><affiliation>Royal Melbourne Hospital, Victoria, Australia<address><country key="AU"></country></address></affiliation></author><author xml:id="author-0005"><persName><forename type="first">G. I.</forename><surname>Taylor</surname></persName><affiliation>Royal Melbourne Hospital, Victoria, Australia<address><country key="AU"></country></address></affiliation></author><idno type="istex">FA0A884ABE135AC61929BEDCB011F2932425752F</idno><idno type="DOI">10.1111/j.1445-2197.2007.04127_11.x</idno><idno type="unit">ANS4127_11</idno><idno type="toTypesetVersion">file:ANS.ANS4127_11.pdf</idno></analytic><monogr><title level="j" type="main">ANZ Journal of Surgery</title><title level="j" type="alt">ANZ JOURNAL SURGERY</title><idno type="pISSN">1445-1433</idno><idno type="eISSN">1445-2197</idno><idno type="book-DOI">10.1111/(ISSN)1445-2197</idno><idno type="book-part-DOI">10.1111/ans.2007.77.issue-s1</idno><idno type="product">ANS</idno><idno type="publisherDivision">ST</idno><imprint><biblScope unit="vol">77</biblScope><biblScope unit="page" from="A64">A64</biblScope><biblScope unit="page" to="A64">A64</biblScope><biblScope unit="page-count">1</biblScope><publisher>Blackwell Publishing Asia</publisher><pubPlace>Melbourne, Australia</pubPlace><date type="published" when="2007-05"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract xml:lang="en" style="main"><p><hi rend="bold">Background </hi> Abdominal donor site flaps, including the Transverse Rectus Abdominis Musculocutaneous (TRAM) and Deep Inferior Epigastric Artery (DIEA) perforator flaps, are the standard in autologous breast reconstruction. With variation in the vascular anatomy of the abdominal wall, preoperative imaging is essential for preoperative planning and reducing intraoperative error. Ultrasound has been used previously with varying results, and the quest continues for optimal preoperative assessment. Computerised Tomography Angiography (CTA) has been recently proposed as a non‐invasive modality for this purpose. This is the first study to formally compare preoperative Doppler ultrasound with CTA for imaging the DIEA.</p><p><hi rend="bold">Methodology </hi> Eight consecutive patients undergoing DIEA perforator flaps for breast reconstruction undertook both CTA and Doppler ultrasound preoperatively. All investigations and procedures were undertaken at the same institution with the same surgeon and radiology team.</p><p><hi rend="bold">Results </hi> CTA was superior at identifying the course of the DIEA, its branching pattern and in visualizing its perforators than Doppler ultrasound. Preoperative CTA was highly specific (100%) and more sensitive in mapping and visualising perforators (p < 0.001). CTA was also proficient at identifying the superficial epigastric arterial system and for effectively displaying the results intraoperatively. CTA was substantially quicker and removed the inter‐observer error associated with Doppler ultrasonography. The study was ceased after eight patients due to the overwhelming benefit of CTA over Doppler.</p><p><hi rend="bold">Conclusions </hi> CTA is a valuable imaging modality for the preoperative assessment of the donor site vascular supply for TRAM and DIEA perforator flaps.</p></abstract><textClass><classCode scheme="tocHeading1">Plastic & Reconstructive Surgery</classCode></textClass><langUsage><language ident="EN"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/FA0A884ABE135AC61929BEDCB011F2932425752F/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley component found"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Asia</publisherName><publisherLoc>Melbourne, Australia</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1445-2197</doi><issn type="print">1445-1433</issn><issn type="electronic">1445-2197</issn><idGroup><id type="product" value="ANS"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="ANZ JOURNAL SURGERY">ANZ Journal of Surgery</title></titleGroup></publicationMeta><publicationMeta level="part" position="05000"><doi origin="wiley">10.1111/ans.2007.77.issue-s1</doi><numberingGroup><numbering type="journalVolume" number="77">77</numbering><numbering type="supplement">s1</numbering></numberingGroup><coverDate startDate="2007-05">May 2007</coverDate></publicationMeta><publicationMeta level="unit" type="abstract" position="252" status="forIssue"><doi origin="wiley">10.1111/j.1445-2197.2007.04127_11.x</doi><idGroup><id type="unit" value="ANS4127_11"></id></idGroup><countGroup><count type="pageTotal" number="1"></count></countGroup><titleGroup><title type="tocHeading1">Plastic & Reconstructive Surgery</title></titleGroup><eventGroup><event type="firstOnline" date="2007-04-24"></event><event type="publishedOnlineFinalForm" date="2007-04-24"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.5 mode:FullText source:Header result:Header" date="2010-04-07"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-04"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-14"></event></eventGroup><numberingGroup><numbering type="pageFirst">A64</numbering><numbering type="pageLast">A64</numbering></numberingGroup><linkGroup><link type="toTypesetVersion" href="file:ANS.ANS4127_11.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="0"></count><count type="tableTotal" number="0"></count><count type="formulaTotal" number="0"></count><count type="referenceTotal" number="0"></count><count type="wordTotal" number="278"></count><count type="linksPubMed" number="0"></count><count type="linksCrossRef" number="0"></count></countGroup><titleGroup><title type="main">PR11
PREOPERATIVE IMAGING FOR DIEA PERFORATOR FLAPS: A COMPARATIVE STUDY OF CT ANGIOGRAPHY AND DOPPLER ULTRASOUND</title><title type="shortAuthors"><i>RACS Annual Scientific Congress</i>, 2006</title><title type="short"><i>ANZ J. Surg.</i> 2007; 77 (Suppl. 1)</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#aff-1-1"><personName><givenNames>W. M.</givenNames><familyName>Rozen</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#aff-1-1"><personName><givenNames>T. J.</givenNames><familyName>Phillips</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#aff-1-1"><personName><givenNames>M. W.</givenNames><familyName>Ashton</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#aff-1-1"><personName><givenNames>D. L.</givenNames><familyName>Stella</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#aff-1-1"><personName><givenNames>R. N.</givenNames><familyName>Gibson</familyName></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#aff-1-1"><personName><givenNames>G. I.</givenNames><familyName>Taylor</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="aff-1-1" countryCode="AU"><unparsedAffiliation>Royal Melbourne Hospital, Victoria, Australia</unparsedAffiliation></affiliation></affiliationGroup><abstractGroup><abstract type="main" xml:lang="en"><p><b>Background </b> Abdominal donor site flaps, including the Transverse Rectus Abdominis Musculocutaneous (TRAM) and Deep Inferior Epigastric Artery (DIEA) perforator flaps, are the standard in autologous breast reconstruction. With variation in the vascular anatomy of the abdominal wall, preoperative imaging is essential for preoperative planning and reducing intraoperative error. Ultrasound has been used previously with varying results, and the quest continues for optimal preoperative assessment. Computerised Tomography Angiography (CTA) has been recently proposed as a non‐invasive modality for this purpose. This is the first study to formally compare preoperative Doppler ultrasound with CTA for imaging the DIEA.</p><p><b>Methodology </b> Eight consecutive patients undergoing DIEA perforator flaps for breast reconstruction undertook both CTA and Doppler ultrasound preoperatively. All investigations and procedures were undertaken at the same institution with the same surgeon and radiology team.</p><p><b>Results </b> CTA was superior at identifying the course of the DIEA, its branching pattern and in visualizing its perforators than Doppler ultrasound. Preoperative CTA was highly specific (100%) and more sensitive in mapping and visualising perforators (p < 0.001). CTA was also proficient at identifying the superficial epigastric arterial system and for effectively displaying the results intraoperatively. CTA was substantially quicker and removed the inter‐observer error associated with Doppler ultrasonography. The study was ceased after eight patients due to the overwhelming benefit of CTA over Doppler.</p><p><b>Conclusions </b> CTA is a valuable imaging modality for the preoperative assessment of the donor site vascular supply for TRAM and DIEA perforator flaps.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>PR11PREOPERATIVE IMAGING FOR DIEA PERFORATOR FLAPS: A COMPARATIVE STUDY OF CT ANGIOGRAPHY AND DOPPLER ULTRASOUND</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>ANZ J. Surg. 2007; 77 (Suppl. 1)</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>PR11
PREOPERATIVE IMAGING FOR DIEA PERFORATOR FLAPS: A COMPARATIVE STUDY OF CT ANGIOGRAPHY AND DOPPLER ULTRASOUND</title></titleInfo><name type="personal"><namePart type="given">W. M.</namePart><namePart type="family">Rozen</namePart><affiliation>Royal Melbourne Hospital, Victoria, Australia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">T. J.</namePart><namePart type="family">Phillips</namePart><affiliation>Royal Melbourne Hospital, Victoria, Australia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M. W.</namePart><namePart type="family">Ashton</namePart><affiliation>Royal Melbourne Hospital, Victoria, Australia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">D. L.</namePart><namePart type="family">Stella</namePart><affiliation>Royal Melbourne Hospital, Victoria, Australia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">R. N.</namePart><namePart type="family">Gibson</namePart><affiliation>Royal Melbourne Hospital, Victoria, Australia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">G. I.</namePart><namePart type="family">Taylor</namePart><affiliation>Royal Melbourne Hospital, Victoria, Australia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="abstract" displayLabel="abstract"></genre><originInfo><publisher>Blackwell Publishing Asia</publisher><place><placeTerm type="text">Melbourne, Australia</placeTerm></place><dateIssued encoding="w3cdtf">2007-05</dateIssued><copyrightDate encoding="w3cdtf">2007</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="words">278</extent></physicalDescription><abstract>Background Abdominal donor site flaps, including the Transverse Rectus Abdominis Musculocutaneous (TRAM) and Deep Inferior Epigastric Artery (DIEA) perforator flaps, are the standard in autologous breast reconstruction. With variation in the vascular anatomy of the abdominal wall, preoperative imaging is essential for preoperative planning and reducing intraoperative error. Ultrasound has been used previously with varying results, and the quest continues for optimal preoperative assessment. Computerised Tomography Angiography (CTA) has been recently proposed as a non‐invasive modality for this purpose. This is the first study to formally compare preoperative Doppler ultrasound with CTA for imaging the DIEA.</abstract><abstract>Methodology Eight consecutive patients undergoing DIEA perforator flaps for breast reconstruction undertook both CTA and Doppler ultrasound preoperatively. All investigations and procedures were undertaken at the same institution with the same surgeon and radiology team.</abstract><abstract>Results CTA was superior at identifying the course of the DIEA, its branching pattern and in visualizing its perforators than Doppler ultrasound. Preoperative CTA was highly specific (100%) and more sensitive in mapping and visualising perforators (p < 0.001). CTA was also proficient at identifying the superficial epigastric arterial system and for effectively displaying the results intraoperatively. CTA was substantially quicker and removed the inter‐observer error associated with Doppler ultrasonography. The study was ceased after eight patients due to the overwhelming benefit of CTA over Doppler.</abstract><abstract>Conclusions CTA is a valuable imaging modality for the preoperative assessment of the donor site vascular supply for TRAM and DIEA perforator flaps.</abstract><relatedItem type="host"><titleInfo><title>ANZ Journal of Surgery</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">1445-1433</identifier><identifier type="eISSN">1445-2197</identifier><identifier type="DOI">10.1111/(ISSN)1445-2197</identifier><identifier type="PublisherID">ANS</identifier><part><date>2007</date><detail type="volume"><caption>vol.</caption><number>77</number></detail><detail type="supplement"><caption>Suppl. no.</caption><number>s1</number></detail><extent unit="pages"><start>A64</start><end>A64</end><total>1</total></extent></part></relatedItem><identifier type="istex">FA0A884ABE135AC61929BEDCB011F2932425752F</identifier><identifier type="DOI">10.1111/j.1445-2197.2007.04127_11.x</identifier><identifier type="ArticleID">ANS4127_11</identifier><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Asia</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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