彩色多普勒超声在股前外侧穿支皮瓣移植术前穿支动脉评估中的作用  

The role of color Doppler ultrasound in the evaluation of perforator location before anterolateral thigh perforator flap transplantation

作　　者：王晓冰[1] 纪旭[2] 马春燕[1] WANG Xiaobing;JI Xu;MA Chunyan(Department of Cardiovascular Ultrasound,The First Hospital of China Medical University,Clinical Medical Research Center of Imaging in Liaoning Province,Shenyang 110001,China;Department of Otorhinolaryngology,The First Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院心血管超声科,辽宁省影像医学临床医学研究中心,沈阳110001 [2]中国医科大学附属第一医院耳鼻咽喉科,沈阳110001

出　　处：《中国医科大学学报》2022年第6期513-517,共5页Journal of China Medical University

基　　金：辽宁省“兴辽英才计划”项目(XLYC1905001)。

摘　　要：目的 探讨彩色多普勒超声在股前外侧(ALT)穿支皮瓣移植术前穿支动脉评估中的作用。方法 选择17例行ALT穿支皮瓣移植术的患者,术前应用彩色多普勒超声在体表定位穿支动脉的穿筋膜点,识别穿支动脉类型和源动脉,将超声结果与术中所见进行对比。结果 超声共定位38条穿支动脉,其中2条未能在术中发现。术中发现1条超声漏报的穿支动脉。超声定位穿支动脉的阳性预测值为94.7%,灵敏度为97.3%。超声识别穿支动脉类型为肌皮支和肌间隔皮支的阳性预测值分别为100.0%和50.0%,灵敏度分别为78.1%和50.0%。超声识别源动脉的阳性预测值较高,而灵敏度较低。结论 彩色多普勒超声可以准确定位ALT穿支皮瓣的穿支动脉,提供较为可靠的穿支动脉类型和源动脉信息,可以作为ALT穿支皮瓣移植术前评估穿支动脉的有效手段。Objective To evaluate the anterolateral femoral perforator location using color Doppler ultrasound before anterolateral thigh(ALT) perforator flap transplantation. Methods We selected 17 patients who were ready for ALT perforator flap transplantation. Color Doppler ultrasound was used to locate the emergence points of the perforators at the fascia and identify the perforator type and source.The flap was designed with a perforator,and the intraoperative results were compared with the ultrasound results. Results In this study,38 perforators were detected using ultrasound,of which two could not be located during the operation. One perforator that was missed through ultrasound was detected during the operation. The positive predictive value and sensitivity of ultrasound for detecting perforators were 94.7% and 97.3%,respectively. The positive predictive values of ultrasound for the two types of perforators,including musculocutaneous and septal cutaneous branches,were 100.0% and 50.0%,respectively,while the corresponding sensitivities were 78.1% and 50.0%,respectively. The positive predictive value for the source artery was high,but the sensitivity was low. Conclusion Color Doppler ultrasound can accurately locate the perforators of the ALT flap and provide more reliable information on the type of perforators and source artery.

关 键 词：超声 股前外侧穿支皮瓣 穿支动脉 

分 类 号：R445.1[医药卫生—影像医学与核医学]