高分辨率彩色多普勒超声技术在下肢皮瓣设计中的应用

Design of axial pattern skin flap on lower limbs with high resolution color Doppler ultrasound

目的评价高分辨率彩色多普勒超声检测技术在下肢轴型皮瓣移植术前检测供区血管中的应用,了解轴型皮瓣血供分布状况。方法采用Acusonsoquoia512及百胜AU4彩色超声检测仪,用彩色多普勒血流成像(CDFI)技术对32例下肢轴型皮瓣内深部动脉干及其肌皮穿支动脉血管的数目、内径、走行方向及分布范围进行检测,进一步作出血流动力学定量分析。结果彩色多普勒超声对32例拟行移植皮瓣的供皮瓣区动脉血管所做的超声影像和血流动力学检测,检出供区皮瓣内深部动脉干32条,肌皮穿支动脉82条,均与临床手术中检查动脉的内径,长度及其分布范围相符。上述供区轴型皮瓣深部动脉干与皮支、穿支检出率100%,通过彩色多普勒超声血流显像及脉冲多普勒血流频谱图,测得下列血流参数:收缩期最大血流速度(Vmax),舒张期最小血流速度(Vmin)、每分血流量(CQ)。结论高分辨率彩色多普勒超声是一种直观,无创性检测方法,可以为术前正确选择皮瓣类型,合理设计手术,以及准确评价轴型皮瓣供血状况提供科学依据。

[Objective] To assess the design of axial pattern flap on lower limbs with high resolution color Doppler ultrasound, and to understand the distribution of vessel in the axial pattern flap! [Methods] The color Doppler flow imaging （CDFI） of high resolution of Acuson Sequoia 512 and Baishen AU4 system was used in the design of axial pattern skin flap, including the Vascular diameter and traveling direction and distribution, the quality of the blood vessel and its flowing dynamics were measured. [Results] Before operation, the blood vessel in donor areas had been completely found （100%）, and the artery was verified by operation. For the axial pattern skin flap in the donor areas, 32 branches of arteries in the depth, 82 branches of the artery in the shallow were found. Vmax in sysytole, Vmin in diastole, CQ in each minutes, were examined by pulsed wave Doppler （PW）. [Conclusionl The high resolution color Doppler flow imaging, could show objectively the quality of the blood vessel inside the donor area, which can provide scientific basis for the design of axial pattern skin flap.