彩色多普勒超声显像对下肢皮瓣移植血管的监测

Examination in Artery of Skin Flap on Lower Limbs with Color Doppler Imaging Ultrasound

【目的】应用彩色多普勒超声显像(Color Doppler flow imaging CDFI)检测技术对下肢皮瓣移植术前供区血管的检测,了解皮瓣血供分布状况。【方法】采用Acuson soquoia 512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42例下肢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等形态学表现进行检测及血流动力学定量分析。【结果】彩色多普勒超声对42例拟行移植皮瓣的供皮瓣区动脉血管形态学表现和血流动力学检测,检出供区皮瓣内深部动脉干42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。上述供区皮瓣深部动脉干与皮支、穿支检出率100%,通过测得下列血流参数: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),提示供区血管质量良好与术中检查结果一致,42例移植皮瓣术后全部成活。【结论】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,以及准确评价皮瓣供血状况提供科学依据。

[Objective]To assess the design of skin flap on lower limbs and to understand the distribution of vessel in the skin flap with color Doppler ultrasound. [Methods]The color Doppler flow imaging （CDFI） of high resolution of Acuson Sequoia 512 and Beishen AU4 system was used in the design of skin flap, including the vascular diam eter 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 then the artery was verified by operation. For the skin flap in the donor areas, 42 branches of arteries were deep, 82 branches were shallow. Vmax in sysytole, Vmin in diastole, CQ in each minute, were examined by pulsed wave Doppler （PW） to prove exactly the quality of the blood vessel and consistency with the results of operation. [Conclusion]The high resolution color Doppler flow imaging could show objectively the quality of the blood vessels inside the donor area, that can provide scientific basis for the design of skin flap.