摘要
目的:探讨多模态超声对腹壁下动脉穿支(deep inferior epigastric perforator,DIEP)皮瓣血管检查有效性,并分析穿支血管的影响因素。方法:纳入2013年2月至2018年10月43例于天津医科大学肿瘤医院使用DIEP皮瓣进行乳房再造术的女性乳腺癌患者,对穿支血管行术前常规及彩色多普勒超声检查,并在超声造影增强状态下行三维重建,直观显示穿支血管的走行分布情况,同时体表标注投影位置。结果:43例患者腹壁下动脉穿支主要分布在脐周5 cm范围内,每侧2~5支,其中28例呈不对称分布。DIEP穿支血管管径与患者腹壁脂肪层厚度呈正相关(r=0.436,P<0.05);血管收缩期峰值血流速度与穿支血管管径呈正相关(r=0.448,P<0.05)。43例患者行超声造影检查后彩色血流信号均能显著增强,其中39例经三维重建后能清晰显示穿支血管与腹壁下动脉主干的关系,4例穿支血管显示欠连续。结论:多模态超声检查在乳腺癌患者DIEP乳房再造术前评估穿支血管具有重要的应用价值,腹壁脂肪层厚度对优势血管的选择有一定影响。
Objective:To examine the effectiveness of multimodal ultrasound in the examination of blood vessels in the deep inferior epigastric perforator(DIEP)flap before breast reconstruction and to analyze the factors influencing the perforator vessels.Methods:Color Doppler ultrasound,contrast-enhanced ultrasound(CEUS),and three-dimensional ultrasound(3D-US)were used to evaluate DIEP vessels before breast reconstruction in 43 patients between February 2013 and October 2018 in Tianjin Medical University Cancer Institute and Hospital.The identification,localization,and spatial relationships of DIEP vessels were analyzed using color Doppler ultrasound,CEUS,and 3D-US.Results:DIEP vessels were mainly distributed within 5 cm around the umbilicus,with 2-5 perforating vessels on each side,and 28 vessels were asymmetrically distributed.The diameter of DIEP vessels was significantly associated with abdominal fat thickness(r=0.436,P<0.05),and the peak systolic blood flow velocity was significantly associated with the diameter of DIEP vessels(r=0.448,P<0.05).With the combination of CEUS and 3D-US,the color blood flow signal was significantly enhanced in 43 patients;of these,39 patients showed the distribution of perforator vessels in the rectus abdominus after reconstruction,while the remaining 4 did not.Conclusions:The application of multimodal ultrasound is valuable in the assessment of perforator vessels before breast DIEP reconstruction.Abdominal fat thickness has a certain influence on the choice of dominant vessels.
作者
刘雪静
路红
徐熠琳
李小康
季宇
刘君君
朱鹰
Xuejing Liu;Hong Lu;Yilin Xu;Xiaokang Li;Yu Ji;Junjun Liu;Ying Zhu(Tianjin Key Laboratory of Cancer Prevention and Therapy,Key Laboratory of Breast Cancer Prevention and Therapy,Tianjin Medical University,Ministry of Education,Tianjin 300060,China)
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2020年第24期1261-1264,共4页
Chinese Journal of Clinical Oncology
基金
天津医科大学肿瘤医院科研项目(编号:Y1611)资助。
关键词
腹壁下动脉
穿支皮瓣
彩色多普勒
超声造影
三维重建
inferior epigastric artery
perforator flap
colour Doppler ultrasound
contrast-enhanced ultrasoud(CEUS)
three-dimensional reconstruction
