Sun Ruimei, Ding Yu, Sun Chuanzheng, Li Xiaojiang, Wang Jinde, Li Lei, Yang Jie, Ren Yanxin, Zhong Zhaoming
Department of Head and Neck Surgery, Third Affiliated Hospital of Kunming Medical University, Kunming, China.
Department of Ultrasonic Examination, Second Affiliated Hospital of Kunming Medical University, Kunming, China.
J Ultrasound Med. 2016 Apr;35(4):767-74. doi: 10.7863/ultra.15.01032. Epub 2016 Mar 11.
To determine the importance of adequate preoperative assessment with color Doppler sonography to assist in the successful transfer of lateral upper arm flaps by studying the lateral upper arm flap with color Doppler sonography and analyzing the anatomic features of the radial collateral artery.
A clinical case-control study was performed. The radial collateral artery was studied with color Doppler sonography in 15 healthy volunteers. The origins, courses, variations, and locations of the perforators of the radial collateral artery were recorded. The results and data from the color Doppler sonographic investigation were compared with an anatomic study that was performed on 22 adult cadaveric upper limb specimens.
The volunteer group (14 of 15 volunteers) and the cadaveric group (19 of 22 upper arm specimens) clearly showed that the branch pattern of the arterial supply was as follows: brachial artery → deep brachial artery → radial collateral artery → posterior radial collateral artery → myocutaneous perforator. Variations in the origin of the radial collateral artery were identified in 1 volunteer bilaterally and in 3 upper arm specimens. The diameters of the artery and vein measured at the distal insertion of the deltoid and the origin of the deep brachial artery were not significantly different between the volunteer and cadaver groups (P > .05). Due to the difference in measuring methods, the length of the vascular pedicles was significantly different between the groups (P < .05).
Color Doppler sonography can facilitate the preoperative assessment of the origin, course, variations, and locations of the radial collateral artery and therefore may increase the success rate of lateral upper arm flap transfer.
通过彩色多普勒超声研究上臂外侧皮瓣并分析桡侧副动脉的解剖特征，以确定充分的术前彩色多普勒超声评估对成功移植上臂外侧皮瓣的重要性。
进行一项临床病例对照研究。对15名健康志愿者的桡侧副动脉进行彩色多普勒超声检查。记录桡侧副动脉穿支的起源、走行、变异及位置。将彩色多普勒超声检查的结果和数据与对22例成人尸体上肢标本进行的解剖学研究结果进行比较。
志愿者组（15名志愿者中的14名）和尸体组（22例上臂标本中的19例）均清楚显示动脉供应的分支模式如下：肱动脉→肱深动脉→桡侧副动脉→桡侧副后动脉→肌皮穿支。在1名志愿者双侧及3例上臂标本中发现桡侧副动脉起源变异。志愿者组和尸体组在三角肌远端附着点和肱深动脉起点处测量的动静脉直径无显著差异（P>.05）。由于测量方法不同，两组间血管蒂长度有显著差异（P<.05）。
彩色多普勒超声有助于术前评估桡侧副动脉的起源、走行、变异及位置，因此可能提高上臂外侧皮瓣移植的成功率。
