彩色多普勒超声在腓肠内侧动脉穿支皮瓣术前评估中的应用

目的：探讨彩色多普勒血流显像在腓肠内侧动脉穿支血管检查中的应用。方法：以术中所见为标准，采用单盲的方法比较手持式声学多普勒及彩色多普勒血流显像对腓肠内侧动脉穿支数目、位置、血管直径检查及判断血管走行中的价值。结果：本研究移植8例皮瓣，共计24支穿支动脉，彩色多普勒血流显像与声学多普勒超声分别确诊22支及17支，误诊为2支和6支，漏诊为2支和7支，二者有显著统计学差异（P＜0.05）。彩色多普勒血流显像测量血管直径与术中测量无统计学差异（P＞0.05）。穿支血管主干分叉点16处，彩色多普勒血流显像与术中所见一致，二者吻合率为100%。8例皮瓣存活良好，术后未出现明显并发症。结论：彩色多普勒血流显像对腓肠内侧动脉穿支血管检测和皮瓣设计方面具有重要价值，能够提高皮瓣移植的可靠性。

Preoperative assessment of medial sural artery perforator flap by color Doppler flow imaging

Objective： To evaluate the application of color Doppler flow imaging （CDFI） in the medial sural artery perfora- tor（MSAP） flap. Methods： CDFI and acoustic Doppler ultrasound were compared in evaluating the number, location, diameter of perforator and main vascular traveling by single-blind trials, the data were compared with intraoperative anatomical finding. Results： In this study eight flaps were transplanted, 24 perforating arteries were involved. Totally 22 MSAPs were found by preoperative CDFI, and 17 by acoustic Doppler ultrasound, 2 and 6 perforators were misdiagnosed respectively, 2 and 7 were missed respectively. There were significant statistical differences between these two methods （P〈0.05）. The measurement of di- ameter by CDFI have no significant statistical difference with the finding in operation（P〉0.05）, and 16 vascular bifurcation de- tected by CDFI was accordance with that found in intraoperative anatomy. Flap survived well with no significant postoperative complications in 8 cases. Conclusion： CDFI is very useful for preoperative planning of medial sural artery perforator flap and increase the reliability of the perforator flap.