CT血管造影在腓肠内侧动脉穿支皮瓣血管定位中的应用  

A preliminary study on application of CT angiography in accurate mapping of the free medial sural artery perforator

作　　者：方早[1] 金淑芳[1] 田卓炜 张陈平[1] 何悦[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院·口腔医学院口腔颌面-头颈肿瘤科,上海市口腔医学重点实验室,上海200011

出　　处：《中国口腔颌面外科杂志》2015年第3期220-225,共6页China Journal of Oral and Maxillofacial Surgery

基　　金：国家自然科学基金(81271112);上海市人才发展计划资助项目(201312);上海交通大学晨星计划A类(201312)~~

摘　　要：目的:探讨运用CT血管造影(CTA)技术定位腓肠内侧动脉穿支的精确性,基于CTA定位下了解腓肠内侧动脉穿支皮瓣的解剖学特征。方法:选取9例舌癌患者,术前利用CTA技术对腓肠内侧动脉穿支进行定位,术中测量腓肠内侧动脉穿支皮瓣的相关解剖数据,测量穿支数量、皮肤穿出点位置、血管蒂长度及皮瓣厚度,运用SPSS 20.0软件包进行配对t检验,与术前CTA测量结果进行比较。结果:腓肠内侧动脉穿支皮瓣血管蒂长,管径与颈部血管匹配,对供区损伤小,CTA定位的血管蒂长度、皮瓣厚度以及血管穿支到坐标原点的距离与术中测量数据进行对比,均无显著差异;术前CTA定位测量准确。结论:术前运用CTA可精确定位穿支位置,利于皮瓣制备,减少手术风险和并发症。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.

关 键 词：腓肠内侧动脉穿支皮瓣 应用解剖 CT血管造影 显微外科 

分 类 号：R654.4[医药卫生—外科学]