术前计算机断层血管造影在腹壁下动脉穿支皮瓣乳房重建中的应用及前景
[Application and prospect of preoperative computed tomographic angiography in deep inferior epigastric artery perforator flap for breast reconstruction].
作者信息
Peng Wen, Lü Chunliu, Zhou Bo, Song Dajiang, Li Zan
机构信息
Department of Head and Neck/Oncology Plastic Surgery, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Province Cancer Hospital, Changsha Hunan, 410008, P.R.China.
出版信息
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Jul 15;34(7):927-931. doi: 10.7507/1002-1892.201907017.
OBJECTIVE
To generalize the application and prospect of computed tomographic angiography (CTA) in deep inferior epigastric artery perforator (DIEP) flap transfer for breast reconstruction.
METHODS
The related literature using CTA for DIEP flap reconstruction of breast in recent years was reviewed and analyzed.
RESULTS
Preoperative CTA can accurately assess the vascular anatomy of the chest and abdomen wall, precisely locating the perforator in the abdominal donor site, and identifying the dominant perforator; guide the selection of intercostal space to explore internal mammary artery and internal mammary artery perforator in the chest recipient vessels. It can also reconstruct the volume of the abdominal flap with reference to the size of the contralateral breast and pre-shape the abdominal flap, which are crucial to formulate the surgical plan and improve the reliability of flap.
CONCLUSION
Preoperative CTA has enormous application potential and prospects in locating donor area perforator, in selecting recipient vessels, and in evaluating breast volume for autologous breast reconstruction with DIEP flap.
目的
总结计算机断层血管造影（CTA）在腹壁下动脉穿支（DIEP）皮瓣转移乳房重建中的应用及前景。
方法
回顾并分析近年来使用CTA进行DIEP皮瓣乳房重建的相关文献。
结果
术前CTA可准确评估胸腹壁血管解剖结构，精确在腹部供区定位穿支，识别优势穿支；指导在胸部受区血管中选择肋间间隙以探查胸廓内动脉及胸廓内动脉穿支。还可参照对侧乳房大小重建腹部皮瓣体积并对腹部皮瓣进行预塑形，这对制定手术方案及提高皮瓣可靠性至关重要。
结论
术前CTA在定位供区穿支、选择受区血管以及评估DIEP皮瓣自体乳房重建的乳房体积方面具有巨大的应用潜力和前景。
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