CDFI与超声造影评估头颈部带蒂皮瓣移植术后血流灌注的对比研究

打开文本图片集

ABSTRACTObjectiveTo compare the clinical value of CDFI and contrast-enhanced ultrasound（CEUS） in evaluating bloodflowperfusionafterpedicledflaptransplantationintheheadandneckregion.MethodsTotall13patientswithheadand neck tumorswhounderwentradical tumorresection inour hospital were prospectivelyselected.Allpatientsunderwent postoperativeCDFIandCEUStoassessblood flow perfusionand evaluate theoutcomesoftheflaps（atotalof15times，among which two patientsunderwent the examination twice）.Taking follow-uporsurgical explorationofflapoutcomesasthegold standard，thediagnostic eficacyand consistencyof CDFIand CEUS inevaluating flapoutcomes were compared.The nontransplantedareaatthesame depth was usedascontrols，the time-intensitycurves were drawn toobtainthetime topeak（TTP）， peak intensity（PI）andareaunderthecurve（AUC），thediferences inquantitativeCEUS parameters werecomparedamong the necroticflaps（5times），viableflaps（10times）andthenon-transplantedarea.ResultsThesensitivityand specificityofCEUS in evaluating flap outcomes were 100% and 80.0% ，respectively，which were higher than those of CDFI（ 60.0% and 70.0% ），with statistically significant differences （both P<0.05 ）.Consistency analysis showed that the agreement between CDFI evaluation results and follow-up or surgical exploration of flap outcomes was low（Kappa=0.286， P =0.264），while the agreementbetween CEUS evaluation results and follow-up or surgical exploration of flap outcomes was good （Kappa=0.727， P =0.003）.Time-intensity curveanalysis showed that the PI of necrotic flaps was lower than thatof the non-transplanted area（ P =0.026），but the diferencesbetweennecroticflapsandviableflapswerenotsignificant.TheAUCofnecroticflapswassignificantlylowerthanthat of the non-transplanted area and viable flaps，with statistical differences（both P<0.05 ）.ConclusionCEUS is significantly superiortoCDFIinevaluating bloodflowperfusionafterpedicledflaptransplantationintheheadandneckregion，demonstrating certain clinical value.

KEYWORDS Ultrasonography，Doppler，color;Contrast agent; Head and neck flaps;Blood flow perfusion

晚期头颈部肿瘤的浸润性生长常累及口咽、食管及周围肌肉结构，根治性切除术后常需移植皮瓣以实现功能重建及外形修复。（剩余8295字）