Application Of Three-dimensional Ultrasound Vascular Reconstruction In The Preoperative Evaluation Of Perforator Flaps

Objective:This study employs high-frequency color doppler ultrasound and contrast-enhanced ultrasound techniques,and improves the ultrasonic contrast vascular reconstruction method.Real-time quantitative angiography and ultrasound surface acoustic locator are used to perform preoperative examinations on patients undergoing perforator flap surgery,in order to explore the clinical value and provide reference for preoperative flap design and intraoperative operation.Methods:A total of 31 patients who underwent perforator flap transplantation in our hospital from July 2012 to December 2016,divided into two groups,were included in this study.16 patients in the group 1 were treated with precise three-dimensional ultrasound quantitative angiography to capture three-dimensional anatomical information and hemodynamic characteristics of the perforating vessels before surgery.15 patients in the group 2 were treated with traditional high-frequency doppler ultrasound to locate piercing-out position(point P)of perforators.The flap was designed and cut before surgery according to detection,and the detected condition and the point P location were compared with the actual condition during the surgery.Results:After surgery,all of the flaps of the group 1 survived;the three-dimensional vascular reconstruction images of the perforating flaps were completely consistent with those seen during the operation.The point P location was accurate,and the preoperative and intraoperative position bias were within 0.4 cm.In group 2,the location bias was larger and there were 2 false positives,and the survival rate of the flap was only 73.3%.The perforation separation time of group 1 was significantly better than that of group 2.Conclusion:Three-dimensional ultrasound quantitative angiography combined with ultrasound acoustic surface locator can be used to capture stable three-dimensional ultrasonic vascular images and accurate body surface localization markers,and realize precise three-dimensional vascular ultrasound navigation,which is conducive to preoperative design as well as guiding intraoperative operation,reducing the blindness of surgery and shortening the operation time.