State-of-the-Art Medical Imaging Supporting Supermicrosurgery: A Scoping Review, Practical Guidelines, and...

Area of Science:

• Medical imaging
• Supermicrosurgery
• Vascular and lymphatic anatomy

Background:

• Supermicrosurgery requires enhanced visualization of microvascular and lymphatic structures.
• Current standard modalities include computed tomography angiography (CTA), magnetic resonance angiography (MRA), and lymphoscintigraphy.

Purpose of the Study:

• To review state-of-the-art medical imaging modalities supporting supermicrosurgery.
• To compare imaging techniques for preoperative planning and intraoperative guidance.

Main Methods:

• Scoping review and case report.
• Analysis of existing and emerging imaging modalities.
• Description of practical guidelines for ultrasound use.

Main Results:

• (Ultra)high-frequency ultrasound (UHFUS) is crucial for flap and lymphatic surgery planning.
• Indocyanine green (ICG) angiography and near-infrared fluorescent lymphography are key in modern surgery.
• Contrast-enhanced magnetic resonance lymphography offers high-resolution lymphatic imaging.
• Laser tomography and photoacoustic imaging show promise for lymphatic surgery.

Conclusions:

• Advanced imaging modalities are essential for improving supermicrosurgery outcomes.
• UHFUS, ICG angiography, and MR lymphography are vital tools.
• Emerging techniques like laser tomography and photoacoustic imaging warrant further investigation.