CTA和超声多普勒在腓骨瓣血供检测中的应用

目的:探讨腓骨瓣游离移植修复上下颌骨缺损术前检测小腿供区血供的方法。方法:12例患者采用游离腓骨瓣修复上下颌骨缺损,小腿供区除物理检查外,常规行彩色多普勒检查,观察腘动脉及分支的走行、口径、腓血管蒂的长度、腓动静脉的口径、皮肤穿支的口径及位置,4例发现有问题则行16层螺旋CT血管造影术(CTA)检查。结果:所有病例未发现血管变异现象,4例其他检查异常或未检出胫前动脉的患者CTA证实腘动脉及分支没有异常。术中发现与术前检查结果一致,术后12例患者均顺利愈合,供区小腿血供没有受到影响。结论:常规行血管造影检查没有必要,但彩色多普勒检查有异常时应行血管造影检查,CTA检查具有无创和直观等优点。

Use of CTA and Color Doppler Flow Imaging in Preoperative Assessment for Fibular Osteomyocutaneous Free Tissue Transfer

Objective: To investigate methods of evaluating preoperatively whether adequate perfusion to the donor extremity will persist after sacrifice of the peroneal pedicle when the fibular flap were used in the reconstruction of mandibular and maxillar defect. Methods: 12 cases of mandibular and maxillar reconstruction with fibular flaps were performed. Besides physical examination, Color Doppler flow imaging examination were performed routinely, to examine popliteal trifurcation, length and diameter of peroneal pedicle, position and diameter of perforaters. When there was any abnormality during Doppler examination in 4 cases, MSCTA examination were used. Results: Vascular variations were not found in all cases. 4 cases of abnormality in other examination were proved to be nomal in the CTA examination. The results of operational finding coincided with preoperational examination. All the 12 cases healed without any complication. The blood supply of lower extremity were not affected after sacrifice of the peroneal pedicle. Conclusion: It is essential to examine blood supply of lower extremity by Color Doppler flow imaging routinely, CTA is a non-invasive and accurate method when abnormality was found during examination of Color Doppler flow imaging.