The Effect of BMI on the Image Quality of CTA Scans for DIEP Flap Breast Reconstruction

BACKGROUND: Computed Tomography Angiography (CTA) imaging is currently the gold standard for the preoperative planning of deep inferior epigastric perforator (DIEP) flap breast reconstruction. Limited research has been performed on the effect of body mass index (BMI) on CTA image quality. Hence, we evaluated the association between BMI and CTA image quality. METHODS: To investigate the association between BMI and image quality, the image quality of 100 CTA scans was scored on a 5-point Likert scale for five different perforator aspects: caliber, location of fascia penetration, intramuscular course, intramuscular branching, and subcutaneous branching. Ordinal regression was performed to determine the effect of BMI on the image quality of the scans. RESULTS: Image quality was scored highest for the subcutaneous branching with a mean score of 3.99 (SD 0.64), while the intramuscular branching showed the lowest scores with a mean of 3.35 (SD 0.82). A higher BMI was associated with a statistically significant lower image quality regarding the assessment of the intramuscular course and intramuscular branching of the perforator, with a regression coefficient of -0.648 and -0.801 respectively. CONCLUSION: A higher BMI was associated with a lower image quality with respect to the assessment of the intramuscular course and intramuscular branching in CTA scans for the preoperative planning of DIEP flap breast reconstruction.