影像学评估腹壁下动脉穿支皮瓣血运的研究进展

Imaging Evaluation of Blood Supply in Deep Inferior Epigastric Perforator Skin Flap

应用不同影像学方法评估游离皮瓣的穿支血管走行及血供特性在乳房再造术中的重要作用腹壁下动脉穿支(leep inferior epigastric perforator,DIFP)皮瓣属穿支皮瓣,穿支血管细小,解剖变异大,术前影像评估穿支血管的位置,管径大小及其走行,对提高手术成功率和安全性具有重要意义评估血管的方法包括手持多普勒、色彩双超声、数字减影血管造影、CT血管造影、核磁血管造影、多层螺旋CT以及吲哚菁绿激光辅助的血管造影等,本文初步介绍不同检查方法评估DIEP皮瓣血管走行及血供特性的优缺点。

The use of various imaging methods to evaluate the characteristics of vascular direction and blood supply in the perforator artery of the free flap plays an important role in breast reconstruction. The deep inferior epigastric perforator （ DIEP ） flap has tiny blood vessels but its anatomy varies in individuals. The use of preoperative imaging on vascular position, pipe diameter size, and vascular direction can improve the success rate and safety of surgery. The evaluation methods used in blood circulation include hand-held doppler, color duplex ultrasound examination, digital subtraction angiography, angiography, imaging angiography, modified discrete cosine transform, and indocyanine green laser-assisted angiography. This article introduces the merits and demerits of different preliminary inspection methods used in evaluating the features of vascular direction and blood supply of the DIEP flap, as well as the distribution of blood vessels durin~ adjuvant breast reconstruction.