Orădan Alex Victor, Georgescu Alexandru Valentin, Jolobai Andrei Nicolae, Pașca Gina Iulia, Corpodean Alma Andreea, Juncan Teodora Paula, Ilie-Ene Alexandru, Muntean Maximilian Vlad
Department of Surgery-Plastic and Reconstructive Surgery, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
Department of Plastic and Reconstructive Surgery, Clinical Rehabilitation Hospital, 400066 Cluj-Napoca, Romania.
J Pers Med. 2024 Sep 13;14(9):969. doi: 10.3390/jpm14090969.
: Perforator mapping is a mandatory tool for the preoperative planning of a microsurgical free flap, especially in breast reconstruction. Numerous methods for mapping have been described. In this study, we investigate the combined use of Dynamic Infrared Thermography (DIRT) and Colour Doppler Ultrasonography (CDUS) only to see whether it can eliminate the need for Computed Tomography Angiography (CTA). : A prospective study was conducted on 33 patients with deep inferior epigastric perforator (DIEP) flaps for breast reconstruction. DIRT, followed by CDUS and CTA, was performed preoperatively and perforators were confirmed intraoperatively. : From 135 hot spots found on DIRT, 123 perforators were confirmed by CDUS (91.11%). A total of 86.66% of the perforator vessels detected on CTA have their correspondent on DIRT, while 95.12% have their correspondent on CDUS. No statistically significant difference ( > 0.05) was found comparing DIRT vs. CTA and CDU vs. CTA. The average DIRT time was 121.54 s and CDUS 232.09 s. The mean sensitivity for DIRT was 95.72% and 93.16% for CDUS. : DIRT combined with CDUS can precisely and efficiently identify suitable perforators without the need for CTA in DIEP breast reconstruction.
穿支血管定位是显微外科游离皮瓣术前规划的必备手段,尤其在乳房重建中。已经描述了多种定位方法。在本研究中,我们仅研究动态红外热成像(DIRT)和彩色多普勒超声(CDUS)的联合应用,以观察其是否可以无需计算机断层血管造影(CTA)。:对33例行腹壁下深动脉穿支(DIEP)皮瓣乳房重建的患者进行了一项前瞻性研究。术前进行DIRT,随后进行CDUS和CTA,并在术中确认穿支血管。:在DIRT上发现的135个热点中,123个穿支血管经CDUS确认(91.11%)。CTA检测到的穿支血管中,共有86.66%在DIRT上有对应点,而95.12%在CDUS上有对应点。比较DIRT与CTA以及CDU与CTA,未发现统计学显著差异(>0.05)。DIRT平均时间为121.54秒,CDUS为232.09秒。DIRT的平均敏感度为95.72%,CDUS为93.16%。:在DIEP乳房重建中,DIRT联合CDUS可以精确、高效地识别合适的穿支血管,而无需CTA。
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