MRA、CTA与DSA在股前外侧皮瓣移植术前应用的对比研究

摘要

Objective To evaluate the value of three preoperative imaging methods in the anterolateral thigh flap (ALT) transplantation.Methods According to preoperative imaging,patients who underwent the ALT flap transplantation were divided into three groups:computed tomography angiography (CTA) group,digital subtract angiography (DSA)group and magnetic resonance angiography (MRA) group.There were fifteen cases in each group.We compared the imaging quality of the ALT artery among these groups and recorded the parameters of lateral femoral circumflex artery,descending branches and perforators including type,course and size.The results from images were compared with intraoperative findings.The success rate and complications were also recorded.Results The preoperative imaging accuracy of the types of the lateral femoral circumflex artery and descending branch was more than 92.3％,with no significant different between any two of three groups (P ＞ 0.05).The difference in diameters of descending branches and perforators from preoperative measurement and from intraoperative measurement was also not significant between any two of the three groups;the success rate and complications were not also obviously different(P ＞ 0.05,P ＞ 0.05,respectively).Conclusions Preoperative mapping using CTA,DSA and MRA is a feasible and reliable method for the flap design in ALT transplantation.As a preoperative evaluation means,CTA and MRA may replace DSA in the ALT transplantation.%目的 对比研究CTA、MRA、DSA影像技术在股前外侧皮瓣移植中的应用.方法 对45例欲行股前外侧皮瓣移植术患者,按术前影像学检查方法不同分为3组:CT血管造影组、数字减影血管造影组、磁共振血管造影组,每组各15例.术前影像学评价旋股外侧动脉的类型、降支起源,测量降支管径;与术中实际观察、测量值进行对比,并且记录股前外侧皮瓣手术成功率与术后并发症发生情况.结果 旋股外侧动脉分型、降支起源类型术前影像学诊断准确率＞92.3％,3组间比较,差异无统计学意义(P＞0.05);旋股外侧动脉降支与皮瓣穿支动脉管径,术前影像学测量值与术中实际测量值,3组间比较差异无统计学意义(P＞0.05);患者皮瓣移植手术成功率与术后并发症发生率3组间比较,差异无统计学意义(P＞0.05).结论 CTA、MRA、DSA影像技术在股前外侧皮瓣的术前评估、设计中具有良好的可行性与可靠性;CTA与MRA可替代DSA在股前外侧皮瓣移植中应用.