Magnetic resonance angiography to evaluate septocutaneous perforators in free fibula flap transfer

Fukaya, Eri; Saloner, David; Leon, Pablo Mendes de; Wintermark, Max; Grossman, Richard F.; Nozaki, Motohiro

doi:10.1016/j.bjps.2009.06.002

Cited by 36 publications

(49 citation statements)

References 22 publications

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“…Moreover, the data of colour duplex ultrasound cannot be applied to three-dimensional reconstruction and preoperative virtual surgery. Due to the above shortcomings of colour duplex ultrasound, several authors in recent years have advocated the routine use of CTA or MRA as part of the preoperative assessment (Foley and Stonely, 2010;Fukaya et al, 2010;Jin et al, 2007;Karanas et al, 2004;Paydarfar et al, 2006). CTA has been used predominantly in the evaluation of atherosclerotic peripheral arterial occlusive disease in symptomatic patients who are candidates for intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Highresolution MRA is also able to determine precisely the anatomical details of the septocutaneous perforators from the peroneal artery, including the exact location of the skin terminus, its course through the septum and its vertical travel distance (Fukaya et al, 2010), but based on only high-resolution MRA data of the lower limb, preoperative virtual surgery would not been carried out if the MRA data of maxilla or mandible was not been obtained. Compared with CT data on the maxilla or mandible, collecting MRI data will increase the patient's cost.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Preoperative three-dimensional reconstruction in vascularized fibular flap transfer

Wang¹,

Deng²,

Li³

et al. 2012

Journal of Cranio-Maxillofacial Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Preoperative three-dimensional reconstruction in vascularized fibular flap transfer

Wang¹,

Deng²,

Li³

et al. 2012

Journal of Cranio-Maxillofacial Surgery

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“…A pilot study [9] showed the successful use of MRA in branching pattern analysis and visualization of septocutaneous perforators at the same time in candidates for fibular free flap transfer operations. Our study involved a relatively large number of legs, and we compared two MRA techniques at the same time.…”

Section: Discussionmentioning

confidence: 99%

“…The position of a peroneal artery septocutaneous perforator along the fibula determines the location of the harvest site and the size and shape of the fibular free flap [9]. Intraoperative ultrasound is commonly used to identify an appropriate septocutaneous perforator.…”

mentioning

confidence: 99%

Time-Resolved and Bolus-Chase MR Angiography of the Leg: Branching Pattern Analysis and Identification of Septocutaneous Perforators

Sandhu

Rezaee

Wright

et al. 2010

American Journal of Roentgenology

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OBJECTIVE The goal of this study was to compare time-resolved MR angiography (MRA) and bolus-chase MRA in the identification of peroneal artery septocutaneous perforators and for classification of the branching pattern of the arterial tree in the leg in a cohort of candidates for fibular free flap transfer operations. MATERIALS AND METHODS Retrospective analysis was performed on imaging data from 53 legs of 27 patients (age range, 27–88 years) who underwent time-resolved MRA (FLASH; TR/TE, 2.5/1.0; flip angle, 22°; voxel dimensions, 1.54 × 1.25 × 1.5 mm; acquisition time, 2.27 s/frame) and bolus-chase MRA (FLASH; 3.2/1.2; flip angle, 25°; voxel dimensions, 0.94 × 0.89 × 1 mm) at 3 T with gadobenate dimeglumine administered at 0.05 and 0.10 mmol/kg, respectively. The branching pattern was analyzed; the total number of septocutaneous perforators for each leg was calculated from the time-resolved and bolus-chase MRA data; and the results were combined. The total and average number of septocutaneous perforators per leg and the frequency of various branching patterns were calculated. The techniques were compared in terms of branching pattern and number of visible septocutaneous perforators. RESULTS A total of 84 septocutaneous perforators (1.58 ± 1.05 [SD] per leg) were identified. Pattern 1A was found in 42 legs; 1B, two legs; 2A, one leg; 2B, one; 3A, four; 3B, one; and 3D, two legs. Classification with time-resolved MRA was successful for 53 legs and with bolus-chase MRA for 51 legs (Z = 0.713, p = 0.24, one-tailed, not significant). Twenty-two septocutaneous perforators were identified with time-resolved MRA and 82 with bolus-chase MRA. CONCLUSION MRA of the leg can be used to investigate the branching pattern and identify septocutaneous perforators in a single step. With the imaging parameters and contrast dose used in this study, septocutaneous perforators can be better identified with bolus-chase MRA, although this result may be partially related to the higher gadolinium dose used in this technique.

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“…16 On the contrary there is enough evidence to suggest that routine preoperative CTA is not requied. 17 Preoperative CTA was not routinely done in our series. Peroneus Longus which is harvested as a component of chimeric free fibula octeocutaneous flap is a type II muscle.…”

Section: Discussionmentioning

confidence: 99%

Free Fibula Flow Through Osteocutaneous Flap in the Upper Extremity Sarcoma Reconstruction

Balakrishnan¹,

Sivarajan²

2015

jemds

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Magnetic resonance angiography to evaluate septocutaneous perforators in free fibula flap transfer

Cited by 36 publications

References 22 publications

Preoperative three-dimensional reconstruction in vascularized fibular flap transfer

Preoperative three-dimensional reconstruction in vascularized fibular flap transfer

Time-Resolved and Bolus-Chase MR Angiography of the Leg: Branching Pattern Analysis and Identification of Septocutaneous Perforators

Free Fibula Flow Through Osteocutaneous Flap in the Upper Extremity Sarcoma Reconstruction

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