影像学技术在术前评估穿支皮瓣血供构型中的价值

摘要/Abstract

摘要： 自20世纪80年代末期提出穿支皮瓣概念以来,采用穿支皮瓣修复各类复合组织缺损已经成为外科修复的新潮流。与传统的肌皮瓣相比,穿支皮瓣的制备避免了不必要的肌肉切取,大大降低了供区损伤和并发症。然而,穿支血管管径细小,血管走行、数目变异较大,往往会增加穿支皮瓣的制备难度。术前影像学评估穿支皮瓣的血供构型,对提高手术成功率,降低手术并发症,减少手术时间具有重要意义。本文旨在系统回顾各种影像学技术在穿支血管血供构型中的应用价值及其优缺点,主要包括手执多普勒超声、彩色多普勒超声、数字减影血管造影、CTA、MRA以及影像学技术引导的立体定向导航技术等,为修复重建外科医师术前选择不同影像学技术评估穿支血管的血供构型提供参考。

关键词: 穿支皮瓣, 影像学, 血供构型

Abstract: Perforator-based microsurgical reconstruction of the compound tissue defect has become the newest method in surgical reconstruction since the introduction of the technique in the late 1980s. Compared with conventional musculocutaneous flap, this approach decreases morbidity of donor site and complication, better preserves muscles. However, the major disadvantage of these flaps is that they can be difficult to harvest. The challenges in flap dissection are a result of the tiny diameter size of perforators and the location, number, and caliber which varies greatly from individuals. Preoperative imaging to assess vascular architecture is vital to improve the success rate, reduce the operative complication, and decrease operating time. The purpose of this article was to review the value of currently available imaging modalities for preoperative planning of perforator vascular architecture, which include hand-held Doppler, color duplex sonography, computer tomography angiography, magnetic resonance angiography and image-guided stereotactic navigation.

Key words: Perforator flap, Imaging, Vascular architecture

黄健, 孙坚. 影像学技术在术前评估穿支皮瓣血供构型中的价值[J]. 中国口腔颌面外科杂志, 2014, 12(1): 82-86.

HUANG Jian, SUN Jian. The value of preoperative imaging of perforator vasculature for planning perforator flaps[J]. China J Oral Maxillofac Surg, 2014, 12(1): 82-86.

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