A comparative study of two commonly used preoperative imagingaided design methods for superficial circumflex iliac artery perforator flap
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摘要: 目的：研究彩色多普勒超声（colorduplexsonography ，CDS ）与CT血管造影（computertomographyangiography ，CTA ）两种常用术前穿支血管定位技术在旋髂浅动脉穿支皮瓣辅助设计及其准确度、敏感度对比的应用，为游离旋髂浅动脉穿支皮瓣修复口腔颌面部肿瘤术后缺损提供理论支持。方法：选取罹患口腔颌面部恶性肿瘤患者需行手术及同期软组织修复29例，术前应用CDS 、CTA 技术对患者双侧腹股沟区旋髂浅动脉穿支进行检测，并记录血管相关检查结果，对检查数据进行统计分析。制备18例游离旋髂浅动脉穿支皮瓣，以术中解剖证实结果为金标准，设计诊断试验，探讨CDS 、CTA 两种技术用于诊断旋髂浅动脉穿支是否存在及管径大小的准确性。结果：18例患者行皮瓣制备，其中1 例术中未探及血管、17例术中行旋髂浅动脉管径测量，平均管径为（0.69± 0.20）mm。在诊断血管有无的试验中，CDS 敏感度为75.0% 、特异度为82.4% ，ROC 曲线下面积为0.79；CTA 敏感度为75.0% 、特异度为94.2% ，ROC 曲线下面积为0.85。术前测量的CDS 、CTA 平均管径分别为（0.84± 0.14）、（ 1.01± 0.19）mm，将CDS 、CTA 技术术前测量的管径大小分别与术中对比，穿支动脉管径（D）分别与CDS 、CTA 测量的管径值两两间比较，差异具有统计学意义（P < 0.05）。 结论：CDS 、CTA 是用于术前检测穿支血管相对可靠的技术。利用CDS 、CTA 术前为旋髂浅动脉穿支皮瓣定位穿支血管，可为术者提供与该穿支血管的走行、毗邻以及穿出点的精确信息，并一定程度反映血管管径大小。Abstract: Objective:To evaluate the accuracy of the application of color Doppler sonography (CDS) and computer tomography angiography (CTA) in preoperative perforator identification and flap design and provide theoretical support for the restoration of oral maxillofacial defect with free superficial circumflex iliac artery perforator flap (SCIAPF).Methods:(1) Preoperative CDS and CTA techniques were performed to map the SCIA perforators of 29adult patients diagnosed with malignant tumor in the oral maxillofacial head and neck regions. These patients were scheduled for concurrent reconstruction surgery. ( 2) A diagnostic test was designed to com-pare the CDS and CTA techniques.Results:(1) A total of 18patients underwent flap preparation. SCIA was not found in one of the pa -tients during surgery, but was observed intra-operatively in the other 17patients. The average SCIA diameter was 0.69± 0.20mm. (2) The diagnostic test showed a CDS sensitivity of 75.0% , a CDS specificity of 82.4% , and an area under the ROC curve of 0.79. The CTA sensitivity was75.0%, the specificity was94.2%, and the area under the ROC curve was0.85. The diameters measured by CDS and CTA were compared with the diameter measured intra-operatively. Significant differences were observed among the three diame -ters (P<0.05). The average diameter measured by CDS was 0.84± 0.14mm. The average diameter measured by CTA was 1.01± 0.19 mm. Conclusion:CDS and CTA are relatively reliable technologies for preoperative detection of perforator vessel. The use of CDS and CTA technology mapping for SCIAPF can provide accurate information about the perforator, including the position of the perforator and the relationship between the peripheral tissues and the caliber of the vessel.
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Keywords:
- head and neck /
- perforator flap /
- imaging /
- reconstruction
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期刊类型引用(4)
1. 张文桐，杨勇，李峰，李斌，王丹丹，陈涛，李建峰. 基于彩色多普勒超声定位的分层削薄旋髂浅动脉穿支皮瓣的临床疗效. 中华烧伤与创面修复杂志. 2025(01): 45-52 . 
百度学术
2. 郭兵，何悦. 旋髂浅动脉穿支皮瓣解剖学研究及在口腔颌面-头颈部的临床应用进展. 中华整形外科杂志. 2022(03): 344-348 . 百度学术
3. 高增阳，刘超，佘立军，陈演志，段求兰，雷彦文，张敬良. 基于"泳裤供区"理念的旋髂浅动脉穿支皮瓣的切取及临床应用. 中华显微外科杂志. 2020(06): 562-565 . 百度学术
4. 王芳，宋慧锋. 旋髂浅动脉穿支皮瓣的研究进展. 中华损伤与修复杂志(电子版). 2016(05): 378-381 . 百度学术
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