{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:05:15Z","timestamp":1789517115412,"version":"build-2803163510"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Contrast-enhanced computed tomography angiography (CTA) is considered the \u201cgold standard\u201d in deep inferior epigastric perforator (DIEP) planning, despite its use of iodine-based contrast and ionizing radiation exposure. In contrast, magnetic resonance angiography (MRA) provides a radiation-free alternative, but conventional MRA requires the use of an expensive and potentially harmful gadolinium-based contrast agent. The development of contrast-free MRA protocols that preserve perforator mapping accuracy represents a promising area of investigation in DIEP flap planning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of this study was to evaluate whether an optimized noncontrast MRA protocol is noninferior to contrast-enhanced CTA in planning for delayed DIEP flap breast reconstruction (BR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cohort study included 131 women (mean age 45.6 \u00b1 7.1; BMI 28.5 \u00b1 3.9 kg\/m2), who underwent delayed unilateral DIEP flap BR. Group 1 (n = 81) underwent a noncontrast MRA with tailored preprocedural preparation, positioning, and scanning. Group 2 (n = 50) underwent standard contrast-enhanced CTA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>MRA significantly reduced operative time (333.0 \u00b1 30.4 vs 348.9 \u00b1 28.8 min; P = .003) and pedicle dissection time (35.7 \u00b1 8.2 vs 40.1 \u00b1 5.9 min; P &amp;lt; .001). The mean fascial incision length was shorter in the MRA group (9.1 \u00b1 1.5 vs 10.6 \u00b1 1.6 cm; P = .025). Diagnostic accuracy was 98.8% vs 99.6% (P = .4145); sensitivity was 98.3% vs 100.0%, and positive predictive value was 97.5% vs 98.7%, for MRA and CTA, respectively. The mean localization difference (\u0394L) was 7.38 \u00b1 2.59 vs 6.96 \u00b1 2.34 mm (P = .238). Perfusion-related complication rates did not differ significantly between groups (P &amp;gt; .05). No significant differences were observed in baseline perforator characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Optimized noncontrast MRA is a clinically reliable, noninferior alternative to CTA in DIEP flap planning, with additional advantages of reduced operative and dissection times.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence: 3 (Therapeutic)<\/jats:title>\n                    <jats:p>For image description, please refer to the figure legend and surrounding text.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/asj\/sjag140","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T19:23:46Z","timestamp":1783452226000},"page":"1137-1146","source":"Crossref","is-referenced-by-count":0,"title":["Noncontrast Magnetic Resonance Angiography vs Contrast-Enhanced Computed Tomography in Deep Inferior Epigastric Perforator Flap Planning: A 4-year Noninferiority Cohort Study"],"prefix":"10.1093","volume":"46","author":[{"given":"Dmitry V","family":"Melnikov","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0283-5370","authenticated-orcid":false,"given":"Elina I","family":"Abdeeva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7210-6566","authenticated-orcid":false,"given":"Sebastian","family":"Cotofana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Semyon I","family":"Ivanov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolay 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