Department of Ultrasound, West China School of Public Health and West China Fourth Hospital, Sichuan University.
Department of Ultrasound, West China School of Public Health and West China Fourth Hospital, Sichuan University.
J Plast Reconstr Aesthet Surg. 2022 Nov;75(11):3964-3969. doi: 10.1016/j.bjps.2022.08.045. Epub 2022 Aug 24.
The fibular myocutaneous flap is a classic flap used to reconstruct oral and maxillofacial defects. This study aimed to evaluate the effectiveness of high-frequency color Doppler ultrasound in detecting the blood vessels in the fibular myocutaneous flap, analyze the influence of variations in the peroneal vessels and perforating peroneal arteries on the surgical design, and explore the value of this technology in preoperatively assessing the blood vessels of the fibular myocutaneous flap.
Twenty-five patients with mandibular disease or defect underwent preoperative evaluation of the blood vessels of the calf by high-frequency color Doppler ultrasound. The inner diameter and peak systolic velocity (PSV) of the peroneal arteries and veins and the perforating peroneal arteries were compared between different groups. The consistency between the perforating peroneal arteries marked by ultrasonography and the intraoperative findings was analyzed.
The initial segment of the peroneal artery had a larger inner diameter (p<0.001) and lower PSV (p<0.05) than the middle segment. The perforating peroneal arteries were mainly distributed in the middle of the fibula. The inner diameter of the perforating peroneal artery was larger in men than in women (p<0.05). In comparison with surgical exploration as the gold standard, high-frequency color Doppler ultrasound results showed good consistency (Kappa=0.684, 95% CI: 0.512-0.856, p<0.001), with a sensitivity of 89.36%, specificity of 78.57%, and accuracy of 85.33%.
High-frequency color Doppler ultrasound can detect, quantitatively evaluate, and accurately mark the peroneal artery and vein and perforating peroneal artery before fibular myocutaneous flap transplantation.
腓骨肌皮瓣是一种经典的用于重建口腔颌面部缺损的皮瓣。本研究旨在评估高频彩色多普勒超声检测腓骨肌皮瓣血管的有效性，分析腓血管变异和穿支腓动脉对手术设计的影响，并探讨该技术在术前评估腓骨肌皮瓣血管中的价值。
25 例下颌骨疾病或缺损患者术前采用高频彩色多普勒超声评估小腿血管。比较不同组之间腓动静脉和穿支腓动脉的内径和收缩期峰值流速（PSV）。分析超声标记的穿支腓动脉与术中发现的一致性。
腓动脉起始段内径较大（p<0.001），PSV 较低（p<0.05）。穿支腓动脉主要分布在腓骨中段。男性穿支腓动脉内径大于女性（p<0.05）。与手术探查作为金标准相比，高频彩色多普勒超声结果具有较好的一致性（Kappa=0.684，95%CI：0.512-0.856，p<0.001），敏感性为 89.36%，特异性为 78.57%，准确性为 85.33%。
高频彩色多普勒超声可在腓骨肌皮瓣移植前检测、定量评估和准确标记腓动静脉和穿支腓动脉。
