Volume-rendered three-dimensional spiral computed tomographic angiography as a planning tool for microsurgical reconstruction in patients who have had operations or radiotherapy for oropharyngeal cancer

Br J Oral Maxillofac Surg. 2007 Oct;45(7):543-7. doi: 10.1016/j.bjoms.2007.03.004. Epub 2007 Apr 30.

Abstract

Three-dimensional spiral computed tomographic angiography (3D-SCTA) is a minimally invasive method of delineating vessels in three-dimensional detail. Our aim was to evaluate the clinical usefulness of volume-rendered three-dimensional SCTA for planning microsurgical reconstruction. Eighteen patients had a spiral computed tomogram (CT) of the extracranial carotid arteries. The volume rendering technique (VRT) was used to visualise the cervical vessels, and the three-dimensional SCTA images evaluated by a staff radiologist. Radiographic and operative findings were correlated in 13 of 18 patients. The anatomical and pathological alterations of vascular anatomy identified by three-dimensional SCTA correlated exactly with operative findings and led to a successful microsurgical reconstruction. Oropharyngeal reconstruction with microvascular free flaps requires accurate evaluation of the vascular system of the carotid arteries, and improves the accuracy of diagnostic decisions. Three-dimensional SCTA enables the surgeon to establish an appropriate treatment plan.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography / methods*
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / surgery
  • Carotid Artery, External / diagnostic imaging*
  • Female
  • Humans
  • Jaw Neoplasms / radiotherapy
  • Jaw Neoplasms / surgery*
  • Male
  • Microsurgery
  • Middle Aged
  • Mouth Neoplasms / radiotherapy
  • Mouth Neoplasms / surgery*
  • Neck / blood supply*
  • Oral Surgical Procedures / methods*
  • Patient Care Planning
  • Plastic Surgery Procedures / methods
  • Surgical Flaps / blood supply
  • Tomography, Spiral Computed / methods*