Detection on distribution and flowing dynamics of the vessel perforators by use of high frequency color ultrasound and contrast-enhanced ultrasound

Abstract

Objective To study the distribution and flowing dynamics of perforator vessel of perforator flap detected by high frequency color ultrasound and contrast-enhaned ultrasound (CEUS) in order to provide reasonable evidence for the design of location and protocol of skin flap.Methods From December 2011 to July 2012,forty-nine patients with soft tissue defects were studied by CEUS and 3D ultrasound.In addition to the position where the blood vessel perforates from muscle into adipose layer,the research emphasized to display the relationship of perforator and its source vessel,detect the number of perforator vessel vascular initial diameter,distribution,and flowing dynamics in the donor site.The straighter and bigger perforators were the first choices.The infection and hardening of the arteries were detected in the accepting-site.Results Among them,forty-three subjucts were observed more clearly with CEUS than conventional ultrasound,totally 117 perforators were found in 49 donr sites.Perforators which were detected by ultrasound were confirmed in the surgery except 30 perforators of the fourth lumbar arteries.The transferred flaps survived completely.Conclusion Perforators can be displayed more clearly and located more accurately by CEUS,which plays a very important role in perforator flap.Three dimentional ultrasound can display excellent images with the information of perforators for clinical surgery. Key words: Contrast-enhanced ultrasound; Perforator flap; Deep inferior epigastric artery perforator; Arteria thoraco-dorsalis artery perforator; Lateral femoral circumflex artery perforator; Peroneal artery perforator; Posterior tibial artery perforator