Comparative Study between Computed Tomography Angiography and Doppler Ultrasound in Reduction Mammoplasty

Background: Breast hypertrophy is a challenging conditionas it is associated with increased body burden and chest oppression.The most devastating complication of breast reductionwhich is post-operative necrosis of the nipple-areola complex(NAC).Objective: This prospective case series study was to investigatethe vascular supply to the NAC and to compare betweenDoppler ultrasound and computed tomography angiography forsurgical planning of breast pedicle in reduction mammoplasty.Patients and Methods: The study was conducted on a totalof 17 cases scheduled for reduction mammaplasty in the PlasticSurgery Department at Mansoura University. PreoperativeCT angiography, Doppler ultrasound, and intraoperative Dopplerultrasound were used to conduct our study. Radiologistsand plastic surgeons work together to conduct a presurgicalplan according to the 3D scan and accompanying measurementparameters. Consequent follow-ups happened immediately after surgery, for up to 6 months, assessing necrosis rates and adverseevents of the NAC.Results: Based on CTA, in right side, we could detect mostdominant Inferior perforators in 58.8%, Superiomedial perforatorin 41.2%, Superior perforator in 11.8%. In left side, Inferiorperforators in 41.2%, Superiomedial perforator in 35.3%, Superiorperforator in 17.6%.Based on Doppler ultrasound, in right breast we could detectmost audible inferior equal to superiomedial perforators in41.2%.It does not necessitate that the most audible perforator byDoppler or the most dominant one by CTA to be selected tosurvive NAC.Conclusions: Doppler ultrasound is a valuable method tohelp in pedicle selection in reduction mammoplasty, which hasmatching results with CT angiography in 75% of the examinedright breasts and 87.5% in the left ones.