【摘要】 目的:目前创伤和肿瘤引起的皮瓣移植手术开展明显增多,术前定位对手术成功率尤为关键,探讨三维增强磁共振血管成像(CE-MRA)在股前外侧皮瓣术前的临床应用价值。方法:对68例供体进行双下肢3DFLASH序列CE-MRA检查,数据采集后使用层块最大强度投影(TS-MIP)进行图像重组,观察和评价与供体皮瓣相关的旋股外侧动脉的起始、分支类型、穿支血管分布情况和覆盖范围等。结果:所查患者旋股外侧动脉获得良好显示,其中Ⅰ型101侧(101/136,74.3%)、Ⅱ型20侧(20/136,14.7%)、Ⅲ型3侧(3/136,2.2%)和Ⅳ型12侧(12/136,8.8%);94侧(94/136,69.1%)旋股外侧动脉显示了3级分支。CE-MRA图清晰显示了粗大穿支血管的起始及在皮下和肌肉间的走行,TS-MIP显示细节最好。结论:3DCE-MRA结合TS-MIP可准确、直观地显示供体股前外侧皮瓣血供及其分布的三维立体信息,有效指导皮瓣的设计。更多还原

【Abstract】 Objective:To evaluate the vasculature of donor anterolateral thigh flaps with three-dimensional contrast-enhanced magnetic resonance angiography(3D CE-MRA).Methods:Sixty-eight donors underwent 3D CE-MRA of lower extremities with a 1.5T scanner.The three-dimensional FLASH sequence was applied for contrasted MR angiography.Thin-slab maximum intensity projection(TS-MIP) was used for revealing the vasculature of arteria cincumflexa femoris lateralis(ACFL),including its origination,branching types,and distribution and covering of perforating artery.Results:The ACFLs in all donors were clearly revealed and classified as branching type A(101,74.3%),type B(20,14.7%),type C(3,2.2%),and type D(12,8.8%).Three-level detail branches were revealed in 94 ACFLs(69.1%).The origin and distribution of perforating arteries were clearly displayed,especially on the TS-MIP.Conclusion:Three-dimensional CE-MRA with TS-MIP can precisely reveal the detail vasculature of donor anterolateral thigh flaps,which may be helpful for flap-designing.更多还原