CT血管造影与手持式多普勒在股前外侧皮瓣术前穿支体表定位的比较  

Preoperative imaging evaluation in anterolateral thigh flap： comparison of computed tomography angiogra- phy and handheld Doppler

作　　者：朱洪章[1] 杨有优[1] 朱庆棠[2] 王东[2] 郑灿镔[2] 周碧[1] 郭辉其 杨旭峰[1] 

机构地区：[1]中山大学附属第一医院放射科,广州510080 [2]中山大学附属第一医院显微创伤骨科 [3]花都区花东镇中心卫生院超声科

出　　处：《中华显微外科杂志》2016年第5期432-436,共5页Chinese Journal of Microsurgery

基　　金：广东省科技计划项目（20128031800383）

摘　　要：目的探讨CT血管造影（CTA）与手持式多普勒（HHD）在术前股前外侧皮瓣穿支的阔筋膜穿出点体表定位的准确性。方法2014年3月至2015年3月，对19例拟行股前外侧皮瓣手术患者均行术前CTA及HHD检查，分别探查皮瓣穿支穿出阔筋膜的穿出点并体表标记，随后再术中进行验证及比较其准确性。结果19例行股前外侧皮瓣移植修复术的患者，皮瓣除1例坏死外其余全部成活。术前CTA、HHD及术中在股前外侧区分别共发现55、55及58条穿支，CTA及HHD在术前穿出点探查的准确度、敏感度、特异性分别为89.23%、91.38%、71.43%及74.24%、82.76%、12.50%。CTA与HHD的穿支体表定位与实际位置距离分别为（11.13 ± 5.89）及（13.73 ± 15.50）mm，两者差异无统计学意义（t=-1.13，P〉0.05）。结论CTA是一种可靠和精准的术前穿支定位方法，在股前外侧皮瓣穿支体表定位的能力优于HHD。Objective To assess the accuracy of preoperative computed tomography angiography （CTA） and handheld Doppler （HHD） perforator body surface mapping for the point of anterolateral thigh （ALT） flap perforators through the deep fascia. Methods From March, 2014 to March, 2015, 19 patients underwent both CTA and HHD to donor site flap perforator exploration and body surface mapping before ALT flap transfer surgery, and the accuracy, sensitivity and specificity of CTA and HHD perforator body surface mapping were compared with the actual intraoper- ative findings. Results All of the ALT flaps survived except 1 case neerose cause by serious infection of recipient site. The 55, 55, 58 perforators were detected by CTA, HHD and actual intraoperative findings, respectively. The accuracy, sensitivity and specificity of CTA and HHD perforator body surface mapping were 89.23%, 91.38%, 71.43% and 74.24%, 82.76% and 12.50%, respectively. The distance of between the actual intraoperative findings and CTA, HHD were （11.13 ± 5.89）, （13.73 ±15.50） mm （t = -1.13, P 〉 0.05）. Conclusion This study demonstrates that CTA is a reliably and effective technology in preoperative flap perforator exploration and body surface mapping, which is more effective and accurate than HHD.

关 键 词：旋股外侧动脉 穿支 股前外侧皮瓣 CT血管造影 手持式多普勒 

分 类 号：R622[医药卫生—整形外科] R816.8[医药卫生—外科学]