COMPARATIVE STUDY BETWEEN COMPUTED TOMOGRAPHY ANGIOGRAPHY AND DOPPLER ULTRASOUND IN REDUCTION MAMMOPLASTY

Abstract

Background: Breast hypertrophy is a challenging condition as it is associated with increased body burden and chest oppression. The most devastating complication of breast reduction which is post-operative necrosis of the nipple-areola complex (NAC). Aim: This prospective case series study was to investigate the vascular supply to the NAC and to compare between Doppler ultrasound and computed tomography angiography for surgical planning of breast pedicle in reduction mammoplasty. Methods: The study was conducted on a total of 17 cases scheduled for reduction mammaplasty in the plastic surgery department at Mansoura University. Preoperative CT angiography, Doppler ultrasound, and intraoperative Doppler ultrasound were used to conduct our study. Radiologists and plastic surgeons work together to conduct a presurgical plan according to the 3D scan and accompanying measurement parameters. Consequent follow-up happened immediately after surgery, up to 6 months, assessing necrosis rates and adverse events of the NAC.Results: Based on CTA, in right side, we could detect most dominant Inferior perforators in 58.8% , Superiomedial perforator in 41.2 % , Superior perforator in 11.8% . In left side, Inferior perforators in 41.2%, Superiomedial perforator in 35.3%, Superior perforator in 17.6%. Based on Doppler ultrasound, in right breast we could detect most audible inferior equal to superiomedial perforators in 41.2% It does not necessitate that the most audible perforator by doppler or the most dominant one by CTA to be selected to survive NAC. Conclusions: Doppler ultrasound is a valuable method to help in pedicle selection in reduction mammoplasty which has matching results with CT angiography in 75%% of examined right breasts and 87.5% in left ones.