Anatomic Imaging of Gluteal Perforator Flaps without Ionizing Radiation: Seeing Is Believing with Magnetic Resonance Angiography

Julie V Vasile; Tiffany Newman; David G Rusch; David T Greenspun; Robert J Allen; Martin Prince; Joshua L Levine

doi:10.1055/s-0029-1225535

Journal of Reconstructive Microsurgery, Inhaltsverzeichnis

J Reconstr Microsurg 2010; 26(1): 045-057
DOI: 10.1055/s-0029-1225535

Anatomic Imaging of Gluteal Perforator Flaps without Ionizing Radiation: Seeing Is Believing with Magnetic Resonance Angiography

Julie V. Vasile¹ , Tiffany Newman² , David G. Rusch⁴ , David T. Greenspun⁵ , Robert J. Allen¹ , Martin Prince³ , Joshua L. Levine¹

¹Center for Microsurgical Breast Reconstruction, New York, New York
²Weill Cornell Imaging at New York Presbyterian, New York, New York
³Columbia and Cornell Universities, New York, New York
⁴Drucker, Genuth, and Augenstein, P.C., Rockville, New York
⁵Greenwich Hospital, Greenwich, Connecticut

Abstract

ABSTRACT

Preoperative imaging is essential for abdominal perforator flap breast reconstruction because it allows for preoperative perforator selection, resulting in improved operative efficiency and flap design. The benefits of visualizing the vasculature preoperatively also extend to gluteal artery perforator flaps. Initially, our practice used computed tomography angiography (CTA) to image the gluteal vessels. However, with advances in magnetic resonance imaging angiography (MRA), perforating vessels of 1-mm diameter can reliably be visualized without exposing patients to ionizing radiation or iodinated intravenous contrast. In our original MRA protocol to image abdominal flaps, we found the accuracy of MRA compared favorably with CTA. With our increased experience with MRA, we decided to use MRA to image gluteal flaps. Technical changes were made to the MRA protocol to improve image quality and extend the field of view. Using our new MRA protocol, we can image the vasculature of the buttock, abdomen, and upper thigh in one study. We have found that the spatial resolution of MRA is sufficient to accurately map gluteal perforating vessels, as well as provide information on vessel caliber and course. This article details our experience with preoperative imaging for gluteal perforator flap breast reconstruction.

KEYWORDS

Gluteal artery perforator flap - superior gluteal artery perforator flap - inferior gluteal artery perforator flap - magnetic resonance imaging angiography - preoperative imaging

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Referenzen

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Julie VasileM.D.

Center for Microsurgical Breast Reconstruction

1776 Broadway, Suite 1200, New York, NY 10019

eMail: jvasile1@msn.com