Three-Dimensional CT Microangiography: A Powerful New Tool for Flap Research

Clinical questions about small blood vessel anatomy often require answers that include the third dimension. The authors presented a new technique that allows both qualitative and quantitative examination of the microcirculation in three dimensions.

In 15 fresh cadavers, arteries supplying major flap territories were injected with a lead oxide/gelatin mixture. Large flap specimens were taken from the anterior abdominal wall, back, and thigh. The specimens were imaged using high resolution spiral CT to produce 3-D reconstructions that could be examined in any tissue plane. Sequential, rotating reconstructions were used to produce high quality video clips. Quantitative and qualitative data from the 3-D reconstructions were recorded and correlated with measurements from subsequent dissection of the same specimens.

The 3-D reconstructions and video clips provided a wealth of detailed three-dimensional information about the microcirculation. A high level of correlation was found between the quantitative finds on CT and dissection.

Three-dimensional CT microangiography is a powerful new tool that will enhance understanding of the microcirculation. Applications will include modified techniques for raising flaps safely, and maximizing flap viability.