关键词: 多层螺旋CT血管成像, 穿支皮瓣, 膝上外侧动脉, 外科皮瓣

Abstract:

Objective　To investigate the potentiality of multislice spiral computed tomographic angiography(MSCTA) on preoperative planning of the perforator flap transplantation.　Methods　From May 2009 to September 2010, 6 cases with soft tissue defects of lower extremity, ankle and foot were treated in our department using perforator flaps. MSCTA was performed preoperatively in all patients scheduled for tissue transfer. MSCTA showed three dimensional images of blood vessels of the lower extremities and perforators. During perforator surgery, MSCTA image assessment allowed us to plan the axis, size and shape of perforator flaps according to the position, calibre and course of pedicled vessels.　Results　MSCTA images showed perforator vessels clearly, including lateral superior genicular artery perforating rami and posterior tibial artery perforating rami in 2 and 4 cases respectively, which was consistant to the course of perforator vessels observed during the operation. 2 cases were treated with the vascularized iliotibial flap transplantation, and 4 cases with the pedicled flaps transfer. Perforator flaps survived well in 5 cases, partly necrosis appeared in only 1 case. After one month, plastic flap recovered well.　Conclusions　MSCTA is valuable for providing anatomic reference during perforator flap transplantation.

Key words: Multislice spiral computed tomographic angiography, Perforator flap, Lateral superior genicular artery, Surgical flaps