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International Journal of Computer Assisted Radiology and Surgery

Erschienen in:

01.07.2014 | Original Article

Three-dimensional prediction of free-flap volume in autologous breast reconstruction by CT angiography imaging

verfasst von: Maximilian Eder, Stefan Raith, Jalil Jalali, Daniel Müller, Yves Harder, Martin Dobritz, Nikolaos A. Papadopulos, Hans-Günther Machens, Laszlo Kovacs

Erschienen in: International Journal of Computer Assisted Radiology and Surgery | Ausgabe 4/2014

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Abstract

Purpose

The diagnostic use of computer tomography angiography (CTA) to identify perforating blood vessels for abdominal free-flap breast reconstruction was extended to estimate the three-dimensional (3D) preoperative flap volume and to compare it with the real intraoperative flap weights in order to (1) evaluate the accuracy of CTA-based 3D flap volume prediction, and (2) to analyze abdominal tissue estimation for required breast volume reconstruction.

Methods

Preoperative CTA was performed in 54 patients undergoing unilateral breast reconstruction with a free, deep, inferior epigastric artery perforator flap. 3D flap volumes (\(\hbox {cm}^{3}\)) based on CTA data were calculated and compared with the actual intraoperative flap weight (g). In addition, a breast volume to flap volume ratio was calculated to analyze whether the estimated 3D abdominal flap volume would match that of the breast to be removed.

Results

40 CTA data sets (74.1 %) fulfilled the technical requirements for a reliable determination of flap volume. 3D CTA flap volume prediction showed no relevant differences to the actual flap weight (p = 0.44) and high correlations (r = 0.998, \(p < 0.001\)), allowing a prediction accuracy within 0.29 \(\pm \) 3.0 % (range: from \(-\)8.77 to 5.67 %) of the real flap weight. Significantly larger flap volumes were harvested compared with the actually required breast volumes (\(p < 0.001\)), leading to an average of 21 % of the remnant flap tissue potentially being discarded.

Conclusions

CTA-based 3D flap volume prediction provides accurate preoperative guidelines concerning the needed amount of abdominal tissue that can be harvested to achieve acceptable symmetry.

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Titel: Three-dimensional prediction of free-flap volume in autologous breast reconstruction by CT angiography imaging
verfasst von: Maximilian Eder
Stefan Raith
Jalil Jalali
Daniel Müller
Yves Harder
Martin Dobritz
Nikolaos A. Papadopulos
Hans-Günther Machens
Laszlo Kovacs
Publikationsdatum: 01.07.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: International Journal of Computer Assisted Radiology and Surgery / Ausgabe 4/2014
Print ISSN: 1861-6410
Elektronische ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-013-0941-4

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Three-dimensional prediction of free-flap volume in autologous breast reconstruction by CT angiography imaging