Int J Comput Assist Radiol Surg - Three-dimensional prediction of free-flap volume in autologous breast reconstruction by CT angiography imaging.

Tópicos

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Resumo

RPOSE: The diagnostic use of computer tomography angiography (CTA) to identify perforating blood vessels for abdominal free-flap breast reconstruction was extended to estimate the three-dimensional (3D) preoperative flap volume and to compare it with the real intraoperative flap weights in order to (1) evaluate the accuracy of CTA-based 3D flap volume prediction, and (2) to analyze abdominal tissue estimation for required breast volume reconstruction.METHODS: Preoperative CTA was performed in 54 patients undergoing unilateral breast reconstruction with a free, deep, inferior epigastric artery perforator flap. 3D flap volumes ([Formula: see text]) based on CTA data were calculated and compared with the actual intraoperative flap weight (g). In addition, a breast volume to flap volume ratio was calculated to analyze whether the estimated 3D abdominal flap volume would match that of the breast to be removed.RESULTS: 40 CTA data sets (74.1 %) fulfilled the technical requirements for a reliable determination of flap volume. 3D CTA flap volume prediction showed no relevant differences to the actual flap weight (p = 0.44) and high correlations (r = 0.998, [Formula: see text]), allowing a prediction accuracy within 0.29 [Formula: see text] 3.0 % (range: from [Formula: see text]8.77 to 5.67 %) of the real flap weight. Significantly larger flap volumes were harvested compared with the actually required breast volumes ([Formula: see text]), leading to an average of 21 % of the remnant flap tissue potentially being discarded.CONCLUSIONS: CTA-based 3D flap volume prediction provides accurate preoperative guidelines concerning the needed amount of abdominal tissue that can be harvested to achieve acceptable symmetry.

Resumo Limpo

rpose diagnost use comput tomographi angiographi cta identifi perfor blood vessel abdomin freeflap breast reconstruct extend estim threedimension d preoper flap volum compar real intraop flap weight order evalu accuraci ctabas d flap volum predict analyz abdomin tissu estim requir breast volum reconstructionmethod preoper cta perform patient undergo unilater breast reconstruct free deep inferior epigastr arteri perfor flap d flap volum formula see text base cta data calcul compar actual intraop flap weight g addit breast volum flap volum ratio calcul analyz whether estim d abdomin flap volum match breast removedresult cta data set fulfil technic requir reliabl determin flap volum d cta flap volum predict show relev differ actual flap weight p high correl r formula see text allow predict accuraci within formula see text rang formula see text real flap weight signific larger flap volum harvest compar actual requir breast volum formula see text lead averag remnant flap tissu potenti discardedconclus ctabas d flap volum predict provid accur preoper guidelin concern need amount abdomin tissu can harvest achiev accept symmetri

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