Ultrasonographic Quantification of Blood Flow in Microsurgical Breast Reconstruction: Correlation with Indocyanine Green Angiography

Although autologous breast reconstruction using the deep inferior epigastric artery perforator (DIEP) flap is a standard procedure, flap perfusion-associated complications remain a concern. This study aimed to investigate the correlation between blood flow information obtained through color Doppler ultrasonography (CDU) and flap perfusion assessed by indocyanine green (ICG) angiography.This prospective study included 30 female patients who underwent DIEP flap breast reconstruction between August 2023 and June 2024. Preoperative flow parameters, including arterial peak velocity, arterial volume flow, and venous peak velocity, were measured using CDU. Flap perfusion was evaluated using ICG angiography.The study demonstrated a positive correlation between venous flow and overall flap blood flow. Arterial peak velocity (<i>r</i> = 0.368, <i>p</i> = 0.046), arterial volume flow (<i>r</i> = 0.455, <i>p</i> = 0.011), and venous peak velocity (<i>r</i> = 0.399, <i>p</i> = 0.029) all showed significant associations with ICG-stained area percentages. These findings suggest that venous flow data can provide valuable information for predicting flap viability.This study demonstrates a significant correlation between flow information obtained through CDU and flap perfusion assessed via ICG angiography in patients undergoing DIEP flap breast reconstruction. Both arterial and venous flow data were shown to be crucial for predicting flap viability, with venous flow exhibiting a notable positive correlation with flap blood flow.