Vascular Mapping of Head and Neck: Computed Tomography Angiography Versus Digital Subtraction Angiography

Kramer, Manuel; Vairaktaris, Eleftherios; Nkenke, Emeka; Schlegel, Karl Andreas; Neukam, Friedrich Wilhelm; Lell, Michael

doi:10.1016/j.joms.2007.05.031

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 2 , Pages 302-307, February 2008

Vascular Mapping of Head and Neck: Computed Tomography Angiography Versus Digital Subtraction Angiography

Manuel Kramer, MD
- Fellow, Institute of Diagnostic Radiology, University of Erlangen-Nuremberg, Erlangen, Germany.
- Address correspondence and reprint requests to Dr Kramer: Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Maxplatz 1, 91054 Erlangen, Germany
Eleftherios Vairaktaris, MD, DMD
- Head, Department of Oral and Maxillofacial Surgery, University of Athens, Athens, Greece.
Emeka Nkenke, MD, DMD
- Assistant Professor of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
Karl Andreas Schlegel, MD, DMD
- Assistant Professor of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
Friedrich Wilhelm Neukam, MD, DMD
- Head, Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
Michael Lell, MD
- Assistant Professor of Radiology, Institute of Diagnostic Radiology, University of Erlangen-Nuremberg, Erlangen, Germany.

Purpose

The aim of the study was to compare multislice computed tomography angiography (MSCTA) to digital subtraction angiography (DSA) for vascular mapping of the head and neck.

Patients and Methods

In 50 patients who were scheduled for microvascular reconstruction of the mandible with osteomyocutaneous flaps, MSCTA was carried out before surgery. DSA served as the method of reference. Selective common carotid angiograms were acquired in 2 projections for both sides of the neck. A 64-slice spiral computed tomography (CT) was carried out with a dual-phase protocol, using the arterial phase images for 3-dimensional CTA reconstruction. Volume rendering was used to visualize MSCTA data.

Results

No adverse reactions or complications occurred during or after the procedures. All CT angiograms were of diagnostic quality. No statistically significant differences between MSCTA and DSA were found for the detection of branches of the external carotid artery that are relevant host vessels for microsurgery neither in the group of 26 patients who had not had surgical treatment before (P = .687), nor in the group of 24 patients who were affected by either a tumor recurrence or an infected osteoradionecrosis (P = .508).