L W Chong1, R Lakshminarayan2, A Akali3. 1. Department of Radiology, Hull Royal Infirmary, Anlaby Road, HU3 2JZ, Hull, UK. Electronic address: leewunchong@nhs.net. 2. Department of Radiology, Hull Royal Infirmary, Anlaby Road, HU3 2JZ, Hull, UK. 3. Department of Plastic Surgery, Hull Royal Infirmary, Anlaby Road, HU3 2JZ, Hull, UK.
Abstract
AIM: To identify and characterise the ideal-sized (defined as at least 2.7 mm based on the experience of plastic surgeons at Hull Royal Infirmary) perforators using magnetic resonance angiography (MRA). The study also evaluated a presumption that perforators on the left are generally larger than on the right. MATERIALS AND METHODS: Fifty consecutive patients who had undergone MRA prior to deep inferior epigastric perforator (DIEP) reconstruction were included. MRA acquisition sequences, MRA images, radiologist reports, and surgical entry database were reviewed retrospectively. Intraoperative findings were compared. The diameter and characteristics of the perforators fulfilling the criteria of being "ideal-sized", at least 2.7 mm were collected. Wilcoxon's test was used to compare the size of the left and right perforators. RESULTS: Ninety-three ideal-sized perforators were identified (diameter of 2.8-4.2 mm). Fifty-one of these were located on the left, and 42 on the right. The left perforators were indeed larger than the right (Wilcoxon's test, p=0.017). Most of the perforators were found in the superior region and medial rows. Additionally, lateral row perforators were observed to have a shorter intramuscular course. CONCLUSION: Contrast-enhanced MRA is a useful preoperative imaging technique to locate ideal DIEPs for breast reconstruction. Perforators on the left were found to be larger than the right, and more ideal-sized perforators were located on the left.
AIM: To identify and characterise the ideal-sized (defined as at least 2.7 mm based on the experience of plastic surgeons at Hull Royal Infirmary) perforators using magnetic resonance angiography (MRA). The study also evaluated a presumption that perforators on the left are generally larger than on the right. MATERIALS AND METHODS: Fifty consecutive patients who had undergone MRA prior to deep inferior epigastric perforator (DIEP) reconstruction were included. MRA acquisition sequences, MRA images, radiologist reports, and surgical entry database were reviewed retrospectively. Intraoperative findings were compared. The diameter and characteristics of the perforators fulfilling the criteria of being "ideal-sized", at least 2.7 mm were collected. Wilcoxon's test was used to compare the size of the left and right perforators. RESULTS: Ninety-three ideal-sized perforators were identified (diameter of 2.8-4.2 mm). Fifty-one of these were located on the left, and 42 on the right. The left perforators were indeed larger than the right (Wilcoxon's test, p=0.017). Most of the perforators were found in the superior region and medial rows. Additionally, lateral row perforators were observed to have a shorter intramuscular course. CONCLUSION: Contrast-enhanced MRA is a useful preoperative imaging technique to locate ideal DIEPs for breast reconstruction. Perforators on the left were found to be larger than the right, and more ideal-sized perforators were located on the left.