Detection On Distribution And Flowing Dynamic Of Cutaneous Perforators Of Lower Leg Arteries With Color Doppler Flow Imaging

Detection on distribution and flowing dynamic of cutaneous perforators of lower leg arteries with color Doppler flowimaging[Abstract]Objective: To study the distribution rules and its flowing dynamics of perforator vessel of lower leg arteries with color Doppler imaging and to provide reasonable location and protocol of skin flap designing.Methods: There were 25 healthy volunteers'cutaneous perforators examined on 44 lower legs,including 44 peroneal arteries and 40 tibial anterior arteries. The quantity,the vascular initial diameter,distribution, the quality of the blood vessel and its flowing dynamics were measured.Results:(1)peroneal artery :In altogether 44 legs studied, 161 cutaneous branches were found. Two to six branches were found on one specimen ,the average number of cutaneous perforators was 3.6. They were classified into two types: I myoeutaneous Perforator(55.3%), II septocutaneous perforator(44.7%).The perforating points of cutaneous branches were mostly (81.3% case) appear within 9~23cm length below the protruding point of head of fibula .Divided the lower leg into equal three parts, the perforating points of cutaneous branches were 36(,22.3%)in the upper part, were 104 (64.4%) in the middle part, and were 21 (13.1%)in the lower part. The average initial internal diameter of cutaneous was 0.95±0.23mm,and vascular flow peak systolic velocity was 0.17±0.08m/s。There were no significant differences in the peak systolic velocity between left and right dominant cutaneous perforators. Male's peak systolic velocity was higher than that of female (P < 0.05)(2)Tibial anterior artery :In altogether 40 legs studied, 236 cutaneous branches were found. Fuor to eight branches were found on one specimen ,the average number of cutaneous perforators was 5.9. septocutaneous perforators of the anterior tibial artery follow a reproducible pattern all over the lower leg (septa I, II and III).The perforating points of cutaneous branches were mostly (55.5% case) appear within 15~27cm length above the lateral maleollus of fibula .Divided the lower leg into equal three parts, the perforating points of cutaneous branches were 100,(41.8%)in the upper part, were115 (48.3%) in the middle part, and were21(9.0%)in the lower part. The average initial internal diameter of cutaneous was 1.0±0.13mm,and vascular flow peak systolic velocity was 0.12±0.06m/s。The perforator with a mean distance to the source artery of 24.3±4.9mm, with a mean distance to the skin surface of 24.3±4.9mm. There were no significant differences in the peak systolic velocity between left and right cutaneous perforators.Conclusion: The color Doppler ultrasonography with high resolution could show the distribution and location clearly,assess the quality of the blood flow of perforators artery,provide scientific basis for planning skin flap.