高分辨率超声检测技术在轴型皮瓣设计中的应用

Design of axial pattern skin flap with high resolution color Doppler

目的:评价高分辨率超声检测技术在轴型皮瓣移植术前检测供区血管中的应用,了解轴型皮瓣的血供分布状况。方法:采用Acuson sequoia 512彩色超声检测仪彩色多普勒血流成像(CDFI)及彩色多普勒能量图(CDE)技术对15例轴型皮瓣内深部动脉于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,进一步做出血流动力学定量分析。结果:彩色多普勒超声对15例拟行移植皮瓣的供皮瓣区动脉血管所作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15条,肌皮穿支动脉49条,均与临床手术中检查动脉的内径、长度及其分布范围的情况相符,上述供区轴型皮瓣深部动脉干及肌皮动脉穿支检出率为100％,未见血管变异及缺如现象。通过彩色多普勒超声血流显像仪和脉冲多普勒血流频谱图,测得下列各项血流参数:收缩期最大血流速度(Vmax),舒张末期血流速度(Vmin),平均血流速度(Vmean),阻力指数(RI),每分血流量(CQ)。结论:高分辨率超声这一直观、无创性检测方法可以为术前正确选用轴型皮瓣类型,合理进行手术设计,以及准确评价轴型皮瓣供区血管状况提供科学依据。

Objective To assess the design of axial pattern flap with high resolution color Doppler, and to understand the distribution of vessel in the axial pattern flaps. Methods The color Doppler flow imaging (CDFI) of high resolution of Acuson Sequoia 512 system was used in the design of axial pattern skin flap with the color Doppler energy (CDE), including the vascular diameter and traveling direction and distribution, the quality of the blood vessel and its flowing dynamics were measured. Results 1. Before operation, the blood vessel in donor areas had been completely found (100%), and then the artery was verified by operation. 2. For the axial pattern skin flap in the donor areas, 15 branches of arteries in the depth, 49 branches of the artery in the shallow were found. 3. Vmax in sysytole, Vmin in diastole, Vmean in average, CQ in each minutes, and Rl were exanined by pulsed wave Doppler (PW) . Conclusion The high resolution color Doppler with the color Doppler energy, 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.