Internal mammary vessels as a model for power Doppler imaging of recipientvessels in microsurgery

The aim of this interdisciplinary study tvas to evaluate power Doppler imag ing as a method of collecting reliable preoperative data concerning the dia meters and topography of exemplary internal mammary vessels as recipient ve ssels in reconstructive microsurgery. Thirteen female patients (range, 37 t o 58 years; mean, 45.6 years) were examined preoperatively with power Doppl er imaging from the first to the fifth intercostal space parasternally and bilaterally. These data are compared with measurements obtained intraoperat ively in each individual. Mean velocity in the artery in the second interco stal space on the right side is 47.11 cm/sec (range, 15 to 90 cm/sec) and o n the left side is 42.25 cm/sec (range, 18 to 95 cm/sec). Mean velocity in the vein in the second intercostal space on the right side is 17.80 cm/sec (range, 10 to 30 cm/sec) and on the left side is 13.06 cm/sec (range, 5.3 t o 32 cm/sec). The topographic results are in close agreement with intraoper ative measurements and previous anatomical studies. Sonographic preoperativ e data of arteries (mean, 1.88 mm) show slightly smaller diameters than int raoperative measurements (mean, 2.08 mm), whereas veins show slightly large r diameters in sonography (mean, 2.33 mm) than intraoperatively (mean, 2.12 mm). Mean sonographic diameter of artery ranges from 2.14 mm (second inter costal space) to 1.46 mm (fifth intercostal space), of the vein from 2.76 ( second intercostal space) to 1.25 mm (fifth intercostal space). In one case , a vein was not detectable. This noninvasive method leads to confirmation of the preoperative choice of the optimal recipient vessels for free tissue transfer and does not harm the patient.