OBJECTIVE: Perfusion-computed tomography (CT) is a promising new technique to assess ischemic lesions caused by ischemic brain stroke. In this study, the use of perfusion-CT scans to predict ischemia in microvascular transplants of the face was examined. STUDY DESIGN: Thirty-eight patients with microvascular latissimus dorsi transplants after tumor surgery were assessed by perfusion-CT scan 34 to 72 hours after surgery. In these cases, clinical examination of the transplant and examination by means of O(2)-probes were either unsuccessful or impossible. An electron beam tomography of the region of interest was performed by using an intravenous nonionic iodine-containing contrast medium (Ultravist 300, Nycomed, Germany) that was applied with an injector at a flow rate of 5 mL/min. Twenty scans with a scanning time of 300 ms and an interscanning time of 3 seconds were carried out. Changes in the Houndsfield units within the transplant as well as the region of the contralateral erector spinae muscle were measured. RESULTS: Central malperfusion resulting in later complete transplant loss was detected in 2 cases. Peripheral malperfusion was found in 6 cases, resulting in localized resection and secondary wound closure. When no malperfusion was registered, the straightforward healing process took place. CONCLUSION: Perfusion-CT scans are of great aid in the assessment of microvascular transplant perfusion in the face, when adequate perfusion is not verifiable clinically or by O(2)-probe because of removal or malfunction.
OBJECTIVE: Perfusion-computed tomography (CT) is a promising new technique to assess ischemic lesions caused by ischemic brain stroke. In this study, the use of perfusion-CT scans to predict ischemia in microvascular transplants of the face was examined. STUDY DESIGN: Thirty-eight patients with microvascular latissimus dorsi transplants after tumor surgery were assessed by perfusion-CT scan 34 to 72 hours after surgery. In these cases, clinical examination of the transplant and examination by means of O(2)-probes were either unsuccessful or impossible. An electron beam tomography of the region of interest was performed by using an intravenous nonionic iodine-containing contrast medium (Ultravist 300, Nycomed, Germany) that was applied with an injector at a flow rate of 5 mL/min. Twenty scans with a scanning time of 300 ms and an interscanning time of 3 seconds were carried out. Changes in the Houndsfield units within the transplant as well as the region of the contralateral erector spinae muscle were measured. RESULTS: Central malperfusion resulting in later complete transplant loss was detected in 2 cases. Peripheral malperfusion was found in 6 cases, resulting in localized resection and secondary wound closure. When no malperfusion was registered, the straightforward healing process took place. CONCLUSION: Perfusion-CT scans are of great aid in the assessment of microvascular transplant perfusion in the face, when adequate perfusion is not verifiable clinically or by O(2)-probe because of removal or malfunction.
Authors: Joe Barfett; Nivethan Velauthapillai; Christian Kloeters; David J Mikulis; Jeffrey D Jaskolka Journal: Int J Cardiovasc Imaging Date: 2012-12 Impact factor: 2.357