Morphometric Analysis of Thigh Perforator Arteries Using CT Angiography: A Bilateral Comparative Study
- 1Department of Anatomy, Faculty of Medicine, Istanbul Atlas University, 34403 Istanbul, Turkey
- 2Department of Anatomy, Faculty of Medicine, Ankara University, 06630 Ankara, Turkey
Abstract
Background/Objectives: The thigh provides several perforator-based donor sites, but comparative computed tomography angiographic data describing anterolateral thigh (ALT), anteromedial thigh (AMT), and posteromedial thigh (PMT) perforators bilaterally remain limited. This study aimed to characterize CTA measurability, caliber, and side-to-side variability across these three territories. Methods: A total of 176 archived CTA records were screened. After predefined clinical/imaging exclusions and reconciliation of duplicated protocols, 49 unique patients with bilateral thigh imaging (98 lower limbs) were included. Patient-level measurable-perforator rates with 95% Wilson confidence intervals (CIs) were calculated. Side-to-side measurability was assessed with exact McNemar tests, territory differences with Cochran’s Q tests, and paired diameters with Wilcoxon signed-rank tests; Holm correction was applied within families of multiple comparisons. Results: PMT perforators were measurable in 75.5% of patients on each side (95% CI 61.9–85.4%), ALT in 51.0% on the left (37.5–64.4%) and 61.2% on the right (47.2–73.6%), and AMT in 24.5% on the left (14.6–38.1%) and 42.9% on the right (30.0–56.7%). Side-to-side measurability differed for AMT (exact McNemar p = 0.0117) but not ALT (p = 0.180) or PMT (p = 1.000). Paired ALT maximum diameter was 1.86 ± 0.27 mm on the left and 1.59 ± 0.42 mm on the right, but the bilateral difference was not statistically significant after Holm correction (adjusted p = 0.0588). No territory showed a statistically significant bilateral diameter difference after multiplicity correction, and overall maximum diameter did not differ among territories (p = 0.408). Among 17 patients with no measurable ALT perforator on either side, 15 (88.2%; 95% CI 65.7–96.7%) had a measurable AMT or PMT perforator. Conclusions: Archived CTA demonstrates substantial regional and bilateral variability in thigh perforator measurability. The three-territory comparison provides anatomical information that may inform individualized preoperative assessment, while the exploratory laterality findings require confirmation using standardized acquisition and reproducibility testing.
Related
- Case Report: Angiography-guided transvenous single-chamber pacemaker implantation in mirror-image dextrocardia with congenitally corrected transposition of the great arteries.
- Tri-Directional Sub-Voxel Displacement and Ipsilateral Territory Decoupling for 3D Bilateral Coronary Artery Tree Reconstruction in Cardiac CT Angiography
- Performance of GPT-4o in CT-based crista galli morphological classification: image-only versus morphometric dataset-driven approaches: a controlled comparative study
- Comparative clinical and molecular profiling of papillary thyroid carcinomas with unilateral and bilateral lateral lymph node metastasis: a retrospective cohort study.
- Superb microvascular imaging versus CT angiography for assessing disease activity in pediatric Takayasu arteritis: a comparative study with high consistency.
BibTeX
@article{cetinok2026morphometric,
title = {{Morphometric Analysis of Thigh Perforator Arteries Using CT Angiography: A Bilateral Comparative Study}},
author = {Hurriyet Cetinok and Ayhan Comert},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15208127},
url = {https://www.mdpi.com/2077-0383/15/20/8127},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Morphometric Analysis of Thigh Perforator Arteries Using CT Angiography: A Bilateral Comparative Study
AU - Hurriyet Cetinok
AU - Ayhan Comert
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15208127
UR - https://www.mdpi.com/2077-0383/15/20/8127
AB - Background/Objectives: The thigh provides several perforator-based donor sites, but comparative computed tomography angiographic data describing anterolateral thigh (ALT), anteromedial thigh (AMT), and posteromedial thigh (PMT) perforators bilaterally remain limited. This study aimed to characterize CTA measurability, caliber, and side-to-side variability across these three territories. Methods: A total of 176 archived CTA records were screened. After predefined clinical/imaging exclusions and reconciliation of duplicated protocols, 49 unique patients with bilateral thigh imaging (98 lower limbs) were included. Patient-level measurable-perforator rates with 95% Wilson confidence intervals (CIs) were calculated. Side-to-side measurability was assessed with exact McNemar tests, territory differences with Cochran’s Q tests, and paired diameters with Wilcoxon signed-rank tests; Holm correction was applied within families of multiple comparisons. Results: PMT perforators were measurable in 75.5% of patients on each side (95% CI 61.9–85.4%), ALT in 51.0% on the left (37.5–64.4%) and 61.2% on the right (47.2–73.6%), and AMT in 24.5% on the left (14.6–38.1%) and 42.9% on the right (30.0–56.7%). Side-to-side measurability differed for AMT (exact McNemar p = 0.0117) but not ALT (p = 0.180) or PMT (p = 1.000). Paired ALT maximum diameter was 1.86 ± 0.27 mm on the left and 1.59 ± 0.42 mm on the right, but the bilateral difference was not statistically significant after Holm correction (adjusted p = 0.0588). No territory showed a statistically significant bilateral diameter difference after multiplicity correction, and overall maximum diameter did not differ among territories (p = 0.408). Among 17 patients with no measurable ALT perforator on either side, 15 (88.2%; 95% CI 65.7–96.7%) had a measurable AMT or PMT perforator. Conclusions: Archived CTA demonstrates substantial regional and bilateral variability in thigh perforator measurability. The three-territory comparison provides anatomical information that may inform individualized preoperative assessment, while the exploratory laterality findings require confirmation using standardized acquisition and reproducibility testing.
SN - 2077-0383
ER -