Abstract:
Objective To examine the effectiveness of multimodal ultrasound in the examination of blood vessels in the deep inferior epigastric perforator (DIEP) flap before breast reconstruction and to analyze the factors influencing the perforator vessels.
Methods Color Doppler ultrasound, contrast-enhanced ultrasound (CEUS), and three-dimensional ultrasound (3D-US) were used to evaluate DIEP vessels before breast reconstruction in 43 patients between February 2013 and October 2018 in Tianjin Medical University Cancer Institute and Hospital.The identification, localization, and spatial relationships of DIEP vessels were analyzed using color Doppler ultrasound, CEUS, and 3D-US.
Results DIEP vessels were mainly distributed within 5 cm around the umbilicus, with 2-5 perforating vessels on each side, and 28 vessels were asymmetrically distributed.The diameter of DIEP vessels was significantly associated with abdominal fat thickness (r=0.436, P < 0.05), and the peak systolic blood flow velocity was significantly associated with the diameter of DIEP vessels (r=0.448, P < 0.05).With the combination of CEUS and 3D-US, the color blood flow signal was significantly enhanced in 43 patients; of these, 39 patients showed the distribution of perforator vessels in the rectus abdominus after reconstruction, while the remaining 4 did not.
Conclusions The application of multimodal ultrasound is valuable in the assessment of perforator vessels before breast DIEP reconstruction.Abdominal fat thickness has a certain influence on the choice of dominant vessels.