Xiaoqin Li, Jing Zhang, Hesong Shen, Xiaoxia Wang, Daihong Liu, Hong Yu, Xiaosong Lan, Jinfang Shi, Xiangfei Zeng, Meiling Liu, Meng Lin, Yong Tan, Bin Zhang, Jiuquan Zhang
J Comput Assist Tomogr . 2022 Jul-Aug;46(4):560-567. doi: 10.1097/RCT.0000000000001320. Epub 2022 Apr 8.
Objective: To objectively and subjectively assess the image characteristics of noise-optimized virtual monoenergetic images [MEI (+)] and polyenergetic images (PEIs) from dual-energy computed tomography angiography and then to explore the clinical value of the optimal MEI (+) in preoperative perforator planning of anterolateral thigh (ALT) flap transplantation.
Methods: Sixteen patients (32 thighs) who underwent lower extremity run-off dual-energy computed tomography angiography for planning ALT flap transplantation were enrolled. One standard PEI and 5 MEI (+) in 10-keV intervals (range, 40-80 keV) were reconstructed. First, we compared the image quality subjectively (branch order, image quality, and vascular network continuity) and objectively (vascular attenuation, image noise, signal-to-noise ratio, and the contrast-to-noise ratio). Then, we compared the clinical value (number, type, source artery, pedicle length, caliber, and location of all sizable perforators) between the optimal MEI (+) and PEI groups.
Results: The 40-keV MEI (+) was rated superior subjective and objective image quality metrics to PEI (all P < 0.001). Compared with PEI, 40 keV MEI (+) increased the number of visible perforators, the percentage of perforators with identifiable types, and the measurable length of perforator pedicle (all P < 0.001).
Conclusions: We recommend 40 keV MEI (+) for the visualization of perforators and their contribution to the selection and location of suitable perforators in preoperative planning for ALT flaps.
Read Full Article Here: https://doi.org/10.1097/rct.0000000000001320