Abstract: PURPOSE: To evaluate the application of CT angiography (CTA) in mapping the medial sural artery perforating branches, and explore the anatomy of the flap. METHODS: Preoperative CTA was performed in mapping the medial sural artery perforating branches in 9 Chinese adult patients with squamous cell carcinoma of the tongue. The perforator flap for tongue reconstruction based on preoperative CTA mapping was operated on the 9 patients, the number and location of perforators, the length of pedicle, thickness of the flap were measured. The discrepancies between perforator mapped by preoperative CTA and by intraoperative exploration were compared using SPSS 20.0 software package for paired t test. RESULTS: The pedicle length was long, the diameter of the vascular pedicle matched the recipient vessel in the neck, with minor donor site complications. The length of pedicle, thickness of the flap and location of the medial sural artery perforators were not significantly different between CTA mapping and interoperative measurement, including the preoperative CTA mapping was precise. CONCLUSIONS: CTA can be used to map the perforators preoperatively and precisely, which is beneficial for surgeons to harvest the flap and reduce surgical risks.

Key words: Medial sural artery perforator flap, Applied anatomy, CT angiogrphy, Microsurgery