超声造影及三维重建对腹壁下动脉穿支皮瓣血管的探索性研究  

Contrast-enhanced ultrasound and 3D reconstruction for assessment of the deep inferior epigastric perforator

作　　者：陆林国[1] 徐智章[2] 刘吉斌 徐秋华[4] 宋树良[1] 

机构地区：[1]同济大学附属东方医院超声科,上海200120 [2]复旦大学医学院附属中山医院超声科 [3]Division of Diagnostic Ultrasound, Department of Radiology, Thomas Jefferson University Hospital, USA [4]上海交通大学附属第九人民医院超声科

出　　处：《中华超声影像学杂志》2014年第6期520-523,共4页Chinese Journal of Ultrasonography

摘　　要：目的应用超声造影技术和三维重建技术检查腹壁下动脉穿支皮瓣（DIEP）血管，全面获取穿支血管的解剖信息，为临床提供更为准确的术前导航。方法在常规超声基础上运用超声造影对43例乳房重建患者行DIEP穿支血管检查，并在超声造影状态下行三维重建。除定位穿支血管出肌点外，力求更清晰、直观地显示穿支的走行、与主干的关系以及穿支在皮瓣内的分支、分布情况。结果超声造影清晰地显示和定位了40例（93％）DIEP穿支血管，并能明确其在肌层的走行、与主干的关系；对41例（95％）DIEP穿支进行重建图像获得较为满意的三维图像，可更全面直观地显示穿支血管的空间结构。所有病例均在术中证实超声所见，术后皮瓣均存活。结论超声造影和三维重建技术能在常规超声基础上更全面、准确地定位和显示穿支血管，为DIEP穿支血管术前和术中发挥重要的导航作用。Objective To assess the deep inferior epigastrie perforator （DIEP） vessels in patients with breast reconstruction flaps by contrast-enhanced ultrasound （CEUS） and three-dimensional ultrasound （3DUS） reconstruction techniques. Methods Conventional ultrasound, CEUS and 3DUS were used to evaluate DIEP vessels of breast reconstruction flaps in 43 patients before surgical procedures. The identification, loealization and spatial relationship of DIEP vessels were analyzed with conventional ultrasound,CEUS and 3DUS methods. The findings of CEUS and 3DUS were compared to conventional ultrasound and surgical outcome.Results Compared to CDFI,40 cases （93%） were observed more clearly with CEUS, and were showed more accurately than conventional ultrasound. 41 cases （95%） could be displayed wonderfully in 3D ultrasound.Perforators which were detected by ultrasound were confirmed in the surgery and the transferred flaps survived completely.Conclusions Perforators can be displayed more clearly and located more accurately by CEUS and 3DUS.CEUS and 3DUS could play a very important role in the preoperative navigation of the DIEP than conventional ultrasound.

关 键 词：超声检查 微气泡 外科皮瓣 穿支血管 

分 类 号：R445.1[医药卫生—影像医学与核医学]