Thoracic perforators (IMAP, LICAP, DICAP) for P-to-P and perforator flaps − analysis of localization and anatomy using computed tomography angiography

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-05-13 DOI:10.1016/j.ejrad.2025.112162

Jonas Brandt , Matthias Aitzetmüller-Klietz , Walter Heindel , Maximilian Kückelhaus , Tobias Hirsch , Max Masthoff , Sascha Wellenbrock

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引用次数: 0

Abstract

Background

Perforator-to-perforator (P-to-P) free flaps and local to regional perforator flaps are increasingly important in thoracic reconstructive surgery. However, limited anatomical and imaging data on internal mammary (IMAPs), lateral (LICAPs), and dorsal intercostal artery perforators (DICAPs) hinder presurgical planning and clinical use. This study aimed to evaluate the feasibility of computed tomography angiography (CTA) for thoracic perforator mapping.

Materials and Methods

Non-ECG triggered CTAs of the thoracoabdominal aorta of patients with suspected aortal pathology were retrospectively reviewed. After applying exclusion criteria (aortal pathology, major hardening artifacts, aortal stent prothesis, anasarca or other thoracic wall pathology), absolute count, localization and diameter of thoracic perforators were analyzed for 150 patients (age: 67.3 ± 15.11, m = 99, f = 51) using integrated imaging software.

Results

Using CTA, IMAPs were detected in 99 % of patients, with a mean count of 3.35 ± 1.30 per patient, typically located in the 3.35 ± 1.30 intercostal space (ICS) and having a mean diameter of 1.41 ± 0.35 mm. LICAPs were present in 91 % of patients, averaging 3.46 ± 1.93 per patient, found in the 9.83 ± 1.41 ICS with a mean diameter of 1.26 ± 0.30 mm. DICAPs were identified in 87 % of patients, with an average of 2.71 ± 1.64 per patient, typically located in the 7.49 ± 2.27 ICS and having a mean diameter of 1.25 ± 0.31 mm.

Conclusions

CTA is capable of non-invasive in vivo anatomical mapping of IMAPs, LICAPs and DICAPs and thus has the potential to guide state-of-the-art plastic surgery.

查看原文本刊更多论文

胸部穿支（IMAP， LICAP， DICAP）用于P-to-P和穿支皮瓣-使用计算机断层血管造影定位和解剖分析

背景：穿支对穿支（P-to-P）自由皮瓣和局部到区域穿支皮瓣在胸部重建手术中越来越重要。然而，有限的解剖和成像数据的乳房内（IMAPs），外侧（LICAPs）和背肋间动脉穿支（DICAPs）阻碍了术前规划和临床应用。本研究旨在评估计算机断层血管造影（CTA）用于胸椎穿支定位的可行性。材料与方法回顾性分析疑似主动脉病变患者的胸腹主动脉非ecg触发cta。150例患者（年龄：67.3±15.11,m = 99, f = 51）应用集成成像软件，应用排除标准（主动脉病理、主要硬化伪影、主动脉支架假体、无血管或其他胸壁病理），分析其绝对数量、定位及胸壁穿支直径。结果CTA检查中，99%的患者检出imap，平均3.35±1.30个/例，位于3.35±1.30肋间隙（ICS），平均直径1.41±0.35 mm。91%的患者存在licap，平均为3.46±1.93个，平均直径为1.26±0.30 mm的ICS为9.83±1.41个。87%的患者发现了dicap，平均每位患者2.71±1.64个，通常位于7.49±2.27个ICS，平均直径为1.25±0.31 mm。结论scta能够对imap， licap和dicap进行无创体内解剖定位，因此有可能指导最先进的整形手术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.