The Value of the Multidetector Row Computed Tomography for the Preoperative Planning of Deep Inferior Epigastric Artery Perforator Flap

Abstract

A preoperative abdominal wall study was conducted using a multidetector scanner in 162 women who had undergone breast reconstruction with abdominal perforator flaps. A map of the abdominal perforator vessels dependent on the deep inferior epigastric artery was created. In the first 36 cases, anatomic dissection of all perforators was performed during surgery. The outcome was then compared with the radiologic findings. In the following 126 cases, the perforator vessel chosen preoperatively by the multidetector scanner was located and dissected directly. In the first 36 cases, an absolute correlation was observed between the radiologic information and intraoperative findings. In the following 126 cases, surgery time and the rate of postoperative complications decreased significantly. The multidetector scanner provides valuable preoperative information enabling identification of the most suitable perforator in view of its caliber, location, course, and anatomic relationships. Once located, we can proceed directly to its dissection during surgery, making it a faster and safer technique.