AJR
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Abstract Freely available
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Fox, M. G.
Right arrow Articles by O'Connor, M. I.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Fox, M. G.
Right arrow Articles by O'Connor, M. I.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

MRI Appearance of Myocutaneous Flaps Commonly Used in Orthopedic Reconstructive Surgery

Michael G. Fox1, Laura W. Bancroft2, Jeffrey J. Peterson2, Mark J. Kransdorf2,3, Sarvam P. TerKonda4 and Mary I. O'Connor5

1 Department of Radiology, University of Virginia, Charlottesville, VA 22908.
2 Radiology Department, Mayo Clinic, 4500 San Pablo Rd., Jacksonville, FL 32224.
3 Department of Radiologic Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000.
4 Department of Plastic and Reconstructive Surgery, Mayo Clinic, Jacksonville, FL 23224.
5 Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL 23224.


Figure 1
View larger version (166K):

[in a new window]
  		Fig. 1A —41-year-old woman with rotational medial gastrocnemius flap used for coverage after debridement for osteomyelitis. Axial proton-density (TR/TE, 4,000/15; echo-train length, 8) image obtained 35 months after surgery shows preserved vascular pedicle (arrows) and flap signal characteristics similar to background muscles.

 

Figure 2
View larger version (87K):

[in a new window]
  		Fig. 1B —41-year-old woman with rotational medial gastrocnemius flap used for coverage after debridement for osteomyelitis. Diagram of rotational gastrocnemius flap.

 

Figure 3
View larger version (92K):

[in a new window]
  		Fig. 2A —39-year-old woman with rectus abdominus free flap to ankle after resection of dermatofibrosarcoma protuberans. Coronal T1-weighted (TR/TE, 683/17) spin-echo MR image at 4 months after placement of free flap (asterisk).

 

Figure 4
View larger version (44K):

[in a new window]
  		Fig. 2B —39-year-old woman with rectus abdominus free flap to ankle after resection of dermatofibrosarcoma protuberans. Diagram of free flap.

 

Figure 5
View larger version (136K):

[in a new window]
  		Fig. 2C —39-year-old woman with rectus abdominus free flap to ankle after resection of dermatofibrosarcoma protuberans. Progressive fatty atrophy of rectus abdominus free flap to ankle is seen. Patient did not receive radiation therapy. Coronal T1-weighted image obtained at 5 months (C), at 15 months (D), at 28 months (E), and at 41 months (F).

 

Figure 6
View larger version (136K):

[in a new window]
  		Fig. 2D —39-year-old woman with rectus abdominus free flap to ankle after resection of dermatofibrosarcoma protuberans. Progressive fatty atrophy of rectus abdominus free flap to ankle is seen. Patient did not receive radiation therapy. Coronal T1-weighted image obtained at 5 months (C), at 15 months (D), at 28 months (E), and at 41 months (F).

 

Figure 7
View larger version (162K):

[in a new window]
  		Fig. 2E —39-year-old woman with rectus abdominus free flap to ankle after resection of dermatofibrosarcoma protuberans. Progressive fatty atrophy of rectus abdominus free flap to ankle is seen. Patient did not receive radiation therapy. Coronal T1-weighted image obtained at 5 months (C), at 15 months (D), at 28 months (E), and at 41 months (F).

 

Figure 8
View larger version (167K):

[in a new window]
  		Fig. 2F —39-year-old woman with rectus abdominus free flap to ankle after resection of dermatofibrosarcoma protuberans. Progressive fatty atrophy of rectus abdominus free flap to ankle is seen. Patient did not receive radiation therapy. Coronal T1-weighted image obtained at 5 months (C), at 15 months (D), at 28 months (E), and at 41 months (F).

 

Figure 9
View larger version (115K):

[in a new window]
  		Fig. 2G —39-year-old woman with rectus abdominus free flap to ankle after resection of dermatofibrosarcoma protuberans. Coronal fast spin-echo T2-weighted (TR/TE, 3,000/95) image shows markedly increased T2-weighted signal at 4 months after flap placement.

 

Figure 10
View larger version (138K):

[in a new window]
  		Fig. 3A —42-year-old man with rectus abdominus rotational flap. Resolution of hyperintense T2-weighted flap signal for high-grade malignant fibrous histiocytoma is seen. Axial conventional T2-weighted (TR/TE 2,930/80) spin-echo MR image obtained 2 months postoperatively displays hyperintense signal in flap (large asterisk) relative to background musculature. Patient had received postoperative radiation, and increased signal is also seen in native muscle of anterior compartment (small asterisk).

 

Figure 11
View larger version (146K):

[in a new window]
  		Fig. 3B —42-year-old man with rectus abdominus rotational flap. Resolution of hyperintense T2-weighted flap signal for high-grade malignant fibrous histiocytoma is seen. Axial conventional T2-weighted (TR/TE, 2,250/80) spin-echo MR image obtained during follow-up at 27 months shows marked atrophy of flap (large asterisk) with near reversion of flap signal to that of adjacent muscles. Slight increased signal is seen within flap because of fatty infiltration. Note slight residual increased signal in radiated muscle (small asterisk).

 

Figure 12
View larger version (121K):

[in a new window]
  		Fig. 4A —72-year-old woman with rectus abdominus flap. Resolution of flap enhancement is seen after resection of well-differentiated liposarcoma. Patient received postoperative radiation. Axial T1-weighted image (A) and enhanced fat-suppressed image (B) obtained 6 months after flap placement shows diffuse enhancement of this rotational flap. Margins of flap are well delineated (arrows) in A.

 

Figure 13
View larger version (126K):

[in a new window]
  		Fig. 4B —72-year-old woman with rectus abdominus flap. Resolution of flap enhancement is seen after resection of well-differentiated liposarcoma. Patient received postoperative radiation. Axial T1-weighted image (A) and enhanced fat-suppressed image (B) obtained 6 months after flap placement shows diffuse enhancement of this rotational flap. Margins of flap are well delineated (arrows) in A.

 

Figure 14
View larger version (132K):

[in a new window]
  		Fig. 4C —72-year-old woman with rectus abdominus flap. Resolution of flap enhancement is seen after resection of well-differentiated liposarcoma. Patient received postoperative radiation. Axial T1-weighted image (C) and enhanced fat-suppressed image (D) obtained at 19 months. Signal intensity of flap now equals that of background muscle. Margins of flap are well delineated (arrows) in C.

 

Figure 15
View larger version (146K):

[in a new window]
  		Fig. 4D —72-year-old woman with rectus abdominus flap. Resolution of flap enhancement is seen after resection of well-differentiated liposarcoma. Patient received postoperative radiation. Axial T1-weighted image (C) and enhanced fat-suppressed image (D) obtained at 19 months. Signal intensity of flap now equals that of background muscle. Margins of flap are well delineated (arrows) in C.

 

Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?



HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2006 by the American Roentgen Ray Society.