Three-dimensional contrast-enhanced magnetic resonance angiography for anterolateral thigh flap outlining: A retrospective case series of 68 patients

Jiang,Chunjing; Lin,Ping; Fu,Xiaoyan; Shu,Jiner; Li,Huimin; Hu,Xiaogang; He,Jianrong; Ding,Mingxing

doi:10.3892/etm.2016.3387

Three-dimensional contrast-enhanced magnetic resonance angiography for anterolateral thigh flap outlining: A retrospective case series of 68 patients

Authors:
- Chunjing Jiang
- Ping Lin
- Xiaoyan Fu
- Jiner Shu
- Huimin Li
- Xiaogang Hu
- Jianrong He
- Mingxing Ding
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Affiliations: Department of Radiology, Jinhua Municipal Central Hospital, Jinhua, Zhejiang 321000, P.R. China, Department of Hand‑Foot Surgery, Jinhua Municipal Central Hospital, Jinhua, Zhejiang 321000, P.R. China, Department of Medical Sciences, Jinhua College of Profession and Technology, Jinhua, Zhejiang 321007, P.R. China, Department of Radiology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, P.R. China
Published online on: May 25, 2016 https://doi.org/10.3892/etm.2016.3387
Pages: 1067-1074

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Abstract

Flap transfer is increasingly used for repairing limb defects secondary to trauma or tumor, and appropriate preoperative planning plays a critical role. The present study aimed to examine the use of three-dimensional (3D) contrast-enhanced magnetic resonance angiography (CE-MRA) in evaluating the blood supply distribution and perforating branch pattern of anterolateral thigh (ALT) flaps. Bilateral donor lower limbs were scanned in 68 patients (136 limbs) using a Siemens Avanto 1.5 T magnetic resonance imaging scanner with a 3D fast low‑angle shot sequence, following the thin‑slab maximum intensity projection (TS‑MIP) technique. The lateral femoral circumflex artery (LFCA) was visualized in all patients: 101 limbs (101/136, 74.3%) were type I; 20 limbs (20/136, 14.7%) were type II; 3 limbs (3/136, 2.2%) were type III; and 12 limbs (12/136, 8.8%) were type IV. Tertiary branches were identified in 94 limbs (94/136, 69.1%). Donor flaps were outlined according to MRA TS‑MIP findings in 4 patients. All flaps survived uneventfully following the transfer. In donor flap outlining, 3D CE‑MRA with the TS‑MIP technique allowed an accurate, direct visualization of the branching pattern and distribution profile of the LFCA supplying the ALT flap.

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