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Original Article Plastic and Aesthetic Research

Utility of multi-detector row computed

tomography angiography versus

Doppler in localization of perforators of

anterolateral thigh flaps

Chandan N. Jadhav , Surinder Singh Makkar , Gautam Biswas , Niranjan Khandelwal 2
1
1
1
1 Department of Plastic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
2 Department of Radio Diagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
Address for correspondence: Dr. Chandan N. Jadhav, 4/126, Terrace Road, Perth, Western Australia 6000, Australia.
E-mail: chandansurgery@gmail.com

Dr. Chandan N. Jadhav, MBBS, MS, MCh, Plastic Reconstructive and Aesthetic Surgeon, Fellowship Hand and
Microsurgery (Australia), DAFPRS Aesthetic Surgery Fellowship (Switzerland), Member of Editorial Board
for Micromedicine-ABMS and reviewer for EJPS, Burns & trauma. Have several publications in indexed peer
reviewed journals. Current research interests are in ADSC in fat grafts.

ABSTRACT
Aim: Anterolateral thigh (ALT) flap is widely used in reconstruction of various defects.
Preoperative imaging facilitates perforator mapping, overcoming intraoperative uncertainty. The
purpose of this study was to investigate the utility of multi-detector row computed tomography
angiography (MDCTA) and a handheld Doppler in locating ALT perforators. Methods: Twenty
patients were randomized into two groups. Group 1 patients received MDCTA and Doppler
studies whereas Group 2 received only a Doppler study. The number, location, course, and source
of all cutaneous and sizable perforators were compared with intraoperative findings. Surgeons’
stress levels during flap harvest and flap harvest time were compared. Results: MDCTA findings
correlated well with intraoperative findings for perforator type and segmental distribution with
100% concordance. Doppler alone had a 52% rate of concordance. The sensitivity and specificity
for MDCTA in demonstrating the presence of perforators were 85.71% and 97.22%, respectively;
whereas for Doppler alone the sensitivity and specificity were 80% and 87.91%, respectively. In
demonstrating perforator source, MDCTA showed a sensitivity of 100% and specificity of 91.66%,
with 100% accuracy. Sensitivity and specificity for sizable perforators were 90% each, with 88.88%
accuracy. Doppler studies were unable to provide this information. Comparison of surgeon stress
levels showed no differences between the two groups, although the time for flap harvest was
significantly shorter in Group 1. Conclusion: MDCTA compared to Doppler is more sensitive,
specific, and accurate with respect to location, course, and source of perforators.

Key words:
Anterolateral thigh; multi-detector row computed tomography angiography; perforator

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How to cite this article: Jadhav CN, Makkar SS, Biswas G,
Khandelwal N. Utility of multi-detector row computed tomography
angiography versus Doppler in localization of perforators of
DOI:
10.20517/2347-9264.2015.64 anterolateral thigh flaps. Plast Aesthet Res 2016;3:52-8.
Received: 31-05-2015; Accepted: 19-11-2015
52 © 2016 Plastic and Aesthetic Research | Published by OAE Publishing Inc.