Jack Brockhoff Reconstructive Plastic Surgery Research Unit, Department of Anatomy and Cell Biology, The University of Melbourne, Grattan Street, Parkville 3050, Victoria, Australia.
J Plast Reconstr Aesthet Surg. 2010 Feb;63(2):289-97. doi: 10.1016/j.bjps.2008.10.007. Epub 2008 Nov 29.
Methods to improve operative outcomes in deep inferior epigastric artery perforator flap surgery have previously focussed on operative technique and postoperative-course modification. Recently, preoperative imaging has become capable of mapping the entire course of perforating vessels, including those vessels as small as 0.3 mm, enabling 'virtual surgery' to be performed preoperatively. This has been shown to facilitate faster and safer surgery. The recent 'Navarra' meeting classified current imaging modalities and discussed the current status of imaging modalities for this role. This article discusses the current expectations and optimal techniques for achieving these outcomes through the available imaging modalities: Doppler ultrasound, colour Doppler (duplex) ultrasound, computed tomography angiography (CTA) and magnetic resonance angiography (MRA). Features of imaging that are of importance to the surgeon are explored, and a consensus statement has been developed that describes exactly what the current imaging modalities should aim to deliver to the surgeon prior to operating, as well as the benefits and pitfalls of each of these modalities. The techniques described herein permit the radiologist and the surgeon to perform virtual surgery together, preoperatively.
方法以改善手术结果在深部腹壁下动脉穿支皮瓣手术以前集中于手术技术和术后课程修改。最近，术前成像已成为能够映射整个过程的穿孔血管，包括那些血管小至 0.3 毫米，使“虚拟手术”能够在术前进行。这已被证明可以促进更快和更安全的手术。最近的“纳瓦拉”会议分类目前的成像方式，并讨论了目前的成像方式的现状，为这个角色。本文讨论了目前的期望和最佳技术，通过现有的成像方式实现这些结果：多普勒超声，彩色多普勒（双功能）超声，计算机断层血管造影（CTA）和磁共振血管造影（MRA）。成像的特征是很重要的外科医生，已经制定了一个共识声明，描述的确切的当前成像方式应旨在提供给外科医生术前操作，以及每个这些模式的优点和缺点。本文所述的技术允许放射科医生和外科医生一起进行虚拟手术，术前。
