Schaverien Mark V, Ludman Catherine N, Neil-Dwyer Jason, McCulley Stephen J
Department of Plastic Surgery, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham, United Kingdom.
Ann Plast Surg. 2011 Dec;67(6):671-4. doi: 10.1097/SAP.0b013e3181fab9ea.
The anatomy of the anterior abdominal wall is highly variable and leads to uncertainty when harvesting a deep inferior epigastric artery perforator flap. Presurgical imaging has been shown to reduce the operating time, as well as reduce the rates of flap and donor site complications. The importance of imaging of the venous system has also been recognized for reducing the risk of venous congestion. The modalities currently available for presurgical imaging include handheld Doppler ultrasound, duplex ultrasound, computed tomographic angiography (CTA), and contrast-enhanced magnetic resonance angiography (CE-MRA). Of these, the most promising are CTA and CE-MRA, and advantages and disadvantages exist for both modalities. In this article, we review the use of CE-MRA for preoperative flap imaging and report our experience with its use in deep inferior epigastric artery perforator flap harvest, as well as compare it with CTA. We also explore the future directions for presurgical flap imaging.
前腹壁的解剖结构高度可变，这导致在切取腹壁下动脉穿支皮瓣时存在不确定性。术前成像已被证明可以缩短手术时间，并降低皮瓣和供区并发症的发生率。静脉系统成像对于降低静脉淤血风险的重要性也已得到认可。目前可用于术前成像的方式包括手持多普勒超声、双功超声、计算机断层血管造影（CTA）和对比增强磁共振血管造影（CE-MRA）。其中，最有前景的是CTA和CE-MRA，这两种方式都有其优缺点。在本文中，我们回顾了CE-MRA在术前皮瓣成像中的应用，并报告了我们在切取腹壁下动脉穿支皮瓣时使用它的经验，同时将其与CTA进行比较。我们还探讨了术前皮瓣成像的未来发展方向。
