摘要
目的总结CT血管造影(computed tomographic angiography,CTA)在腹壁下动脉穿支(deep inferior epigastric artery perforator,DIEP)皮瓣乳房再造中的应用进展,并简要分析其应用前景。方法查阅近年来国内外有关CTA在DIEP皮瓣乳房再造中应用的相关文献,并进行分析和总结。结果术前CTA对胸腹壁的血管解剖结构可进行精确评估,在腹部供区可精确定位穿支,识别优势穿支;在胸部受区可指导探查胸廓内动脉肋间隙以及胸廓内动脉穿支分支的选择;参照对侧乳房大小进行腹部皮瓣容积重建,精确预构腹部皮瓣的大小,对手术方案的制定以及手术安全性的提高均有着至关重要的作用。结论术前CTA在DIEP皮瓣乳房再造领域的供区穿支定位、受区血管选择以及乳房容积评估方面具有巨大的应用潜力。
Objective To generalize the application and prospect of computed tomographic angiography CTA in deep inferior epigastric artery perforator(DIEP)flap transfer for breast reconstruction.Methods The related literature using CTA for DIEP flap reconstruction of breast in recent years was reviewed and analyzed.Results Preoperative CTA can accurately assess the vascular anatomy of the chest and abdomen wall,precisely locating the perforator in the abdominal donor site,and identifying the dominant perforator;guide the selection of intercostal space to explore internal mammary artery and internal mammary artery perforator in the chest recipient vessels.It can also reconstruct the volume of the abdominal flap with reference to the size of the contralateral breast and pre-shape the abdominal flap,which are crucial to formulate the surgical plan and improve the reliability of flap.Conclusion Preoperative CTA has enormous application potential and prospects in locating donor area perforator,in selecting recipient vessels,and in evaluating breast volume for autologous breast reconstruction with DIEP flap.
作者
彭文
吕春柳
周波
宋达疆
李赞
PENG Wen;Lü Chunliu;ZHOU Bo;SONG Dajiang;LI Zan(Department of Head and Neck/Oncology Plastic Surgery,the Affiliated Cancer Hospital of Xiangya School of Medicine,Central South University/Hunan Province Cancer Hospital,Changsha Hunan,410008,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2020年第7期927-931,共5页
Chinese Journal of Reparative and Reconstructive Surgery
基金
湖南省自然科学基金面上项目(2018JJ2242、2018JJ2241)
湖南省肿瘤整形外科临床医学研究中心平台建设专项资助(2013TP4087)
湖南省科卫联合项目(2018JJ6028)
湖南省卫健委课题(B2019092)。
关键词
CT血管造影
乳房再造
腹壁下动脉穿支皮瓣
自体组织移植
Computed tomographic angiography
breast reconstruction
deep inferior epigastric artery perforator flap
autologous tissue transplantation
