CT血管造影和磁共振血管造影在股前外侧穿支皮瓣移植术前评估中的应用

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摘要目的：探讨CT血管造影（CTA）、磁共振血管造影（MRA）在股前外侧穿支皮瓣移植术前评估中应用价值。方法：选择欲行股前外侧穿支皮瓣移植术的患者60例，并随机分为CTA组和MRA组，分别行CTA检查和MRA检查，每组各30例。对比分析术前影像测量和术中测得的穿支动脉管径以及穿支定位点径线距离，用Fisher精确概率检验比较分析图像质量、穿支动脉的类型和穿支定位点诊断准确率以及手术成功率和并发症发生率。结果：2组图像质量优良率比较差异无统计学意义（P＞0.05）；2组穿支动脉类型诊断准确率较高且均为92.9%；2组穿支动脉管径以及定位点径线的影像测量值与实际测量值比较差异均无统计学意义（P＞0.05）；2组手术成功率和并发症发生率差异均无统计学意义（P＞0.05）。结论：CTA、MRA检查在股前外侧穿支皮瓣的术前评估、设计中体现出良好的可行性与可靠性，具有较高的应用价值。

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	王挺
	赵振华
	杨建峰
	孙文东

关键词 ：体层摄影术, X线计算机；磁共振成像；外科皮瓣

Abstract：Objective: To evaluate the value of computed tomography angiography (CTA) and magnetic resonance angiography (MRA) in the anterolateral thigh perforator flap (ALTPF) transplantation. Methods: According to preoperative imaging, patients who underwent the ALTPF transplantation were divided into two groups: computed tomography angiography (CTA) Group and magnetic resonance angiography (MRA) Group. Thirty cases were in each group. The parameters of perforator size and origin location in the ALTPF were compared between preoperative and operation by paired t-test; The imaging quality of CTA and MRA and the parameters of perforator course and origin location measured by CTA and MRA were compared between preoperative and operation by Fisher exact test; The success rate and complications of operation between CTA group and MRA group were also compared. Results: There was no significant difference in imaging quality between CTA Group and MRA Group (P>0.05). Comparing preoperative measurement with operation findings, there was no significant difference between two Groups in preoperative imaging accuracy of the types of the perforators, the diameters and the origin location of perforators, and the operation success rate and complications (all P>0.05). Conclusion: Preoperative mapping using CTA and MRA is a feasible and reliable method for the flap design and preoperative evaluation in ALTPF transplantation.

Key words： tomography, X-Ray computer magnetic resonance imaging surgical flap

收稿日期: 2016-09-21

作者简介: 王挺（1975-），男，浙江绍兴人，副主任医师。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2017/V47/I4/268

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