Rozen W M, Ashton M W, Stella D L, Ferris S, White D C, Phillips T J, Taylor G I
Jack Brockhoff Reconstructive Plastic Surgery Research Unit, Department of Anatomy and Cell Biology, The University of Melbourne, Parkville, Victoria, Australia.
Microsurgery. 2008;28(4):227-32. doi: 10.1002/micr.20485.
The anterolateral thigh flap is an increasingly popular reconstructive option despite uncertainty in its perforator anatomy. Perforators are not always present, vary in size and intramuscular course, and have variable cutaneous courses and supply. As such, preoperative imaging has become favored.
The current study describes the preliminary use of two new modalities for preoperative imaging: computed tomography (CT) Angiography and CT-guided stereotaxy. These have been utilized in the preoperative imaging of two patients undergoing ALT flap reconstruction. Each patient underwent each of these techniques combined with Doppler ultrasound, the previous standard modality. The size, location, and course of perforators were explored and compared with operative findings.
Both techniques are technically feasible, highly accurate, and provide more information to the surgeon than ultrasound.
CT Angiography and CT-guided stereotaxy are useful adjuncts to Doppler ultrasound for imaging perforators prior to ALT flaps. A larger study is suggested to quantify the accuracy of these techniques.
尽管股前外侧皮瓣穿支血管的解剖结构尚不确定，但它仍是一种越来越受欢迎的重建选择。穿支血管并非总是存在，其大小和肌内走行各异，皮肤走行和供血也各不相同。因此，术前影像学检查备受青睐。
本研究描述了两种术前影像学检查新方法的初步应用：计算机断层扫描（CT）血管造影和CT引导立体定位。这两种方法已用于两名接受股前外侧皮瓣重建患者的术前影像学检查。每位患者均接受了这两种技术，并结合了之前的标准检查方法——多普勒超声。对穿支血管的大小、位置和走行进行了探究，并与手术结果进行了比较。
这两种技术在技术上都是可行的，准确性很高，并且比超声为外科医生提供了更多信息。
CT血管造影和CT引导立体定位是在股前外侧皮瓣术前对穿支血管进行成像时，多普勒超声的有用辅助手段。建议开展更大规模的研究以量化这些技术的准确性。
