目的 研究CT血管造影(CTA)与彩色多普勒超声成像技术对足趾供区血管情况进行术前评估的临床意义.方法 自2014年1月至2014年12月,25例手指缺损患者行足趾移植再造手术,术前采用CTA与彩色多普勒成像技术,检测患者供区第一跖背动脉的走行、起始内径大小情况及距皮肤距离,将供区血管走行、毗邻精准定位,标测、量化血管起始内径. 结果 25例患者足部第一跖背动脉均能在彩色多普勒和CTA检测中显现.术前两种检测方法所得血管走向、充盈情况与术中一致.第一跖背动脉起始内径在B超、CTA和手术时测量分别为(1.20±0.25) mm、(1.41±0.15) mm和(1.3±0.2) mm,差异有统计学意义(P＜0.05),而距皮肤距离三者分别为(9.20±3.06) mm、(10.32±2.76)和(10.2±2.6),差异无统计学意义(P＞0.05).25例再造指均顺利成活. 结论 CTA与彩色多普勒成像技术相结合用于足趾移植再造拇指术前检查,能准确反映供区血管的解剖学结构特点并提供个体化的、清晰的足部血供图像,对拇手指再造术术前评估足部供区血供具有重要的临床价值.%Objective To explore the clinical significance of the precision evaluation of computed tomography angiography and color Doppler image formation technology to the condition of the vascular system in the donor site.Methods From January,2014 to December,2014,CTA and color Doppler were used to examine conditions of the first dorsal metatarsal artery's courser and the size of original caliber in 25 patients with thumb or finger defected.Also the distance between skin and the first dorsal metatarsal artery.The accurate positions and adjacent relations of vessels in donor site were precisely marked and then the vessel original caliber was measured.Results All the first dorsal metatarsal arteries of 25 cases can be appeared clearly in CTA and color Doppler.Blood vessels line and filling results were completely consistent in intraoperative findings.The difference of the vessel original average caliber was statistically significant (P ＜ 0.05) (1.20 ± 0.25 mm,1.41 ± 0.15 mm and 1.3 ±0.2 mm in Doppler,CTA and operation,respectively) while the distance was not significant (P ＞ 0.05)(9.20 ±3.06 mm,10.32 ± 2.76 mm and 0.2 ± 2.6 mm in Doppler,CTA and operation,respectively) All the 25 transplanted toes were survived.Conclusion CTA combined color Doppler image formation technology in thumb or finger reconstruction can objectively reflect the real situation of the vessels in donor sites,and the structural characteristics and classification of anatomy for individualized,and has important clinical value in preoperative foot blood supply assessment.
展开▼
