Contrast harmonic ultrasound and indocyanine-green fluorescence video angiography for evaluation of dermal and subdermal microcirculation in free parascapular flaps

Prantl, Lukas and Schmitt, St. and Geis, S. and Tsui, T. Y. and Lamby, P. and Nerlich, M. and Kubale, R. and Zorger, N. and Herold, T. and Feuerbach, S. and Jung, E. M. (2008) Contrast harmonic ultrasound and indocyanine-green fluorescence video angiography for evaluation of dermal and subdermal microcirculation in free parascapular flaps. CLINICAL HEMORHEOLOGY AND MICROCIRCULATION, 38 (2). pp. 105-118. ISSN 1386-0291, 1875-8622

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Abstract

Purpose: Contrast harmonic ultrasound (CHI) with a linear transducer is a new diagnostic approach that allows dynamic and quantitative flow detection of tissue perfusion in microsurgery. The aim of the study was the evaluation of perfusion of the dermal and subdermal layers of microvascular tissue transplants with CHI in comparison to ICG-fluorescence angiography. Material and method: In a prospective clinical study Indocyanine-Green Fluorescence Video Angiography and Contrast Enhanced High Resolution Ultrasound (5-10 MHz; linear transducer; Logiq 9; GE) were used for evaluation of the microcirculation in 10 transplanted free parascapular flaps. Two regions were analysed, the centre of the flap and the region of the anastomosis. The perfusion patterns of both methods were compared. Results: The perfusion indexes measured by ICG-fluorescence angiography correlated very precisely in all patients with the quantitative perfusion curves of contrast-enhanced US with CHI. Two flaps with slow filling and low dye intensity showed low contrast enhancement in CHI with modified perfusion curves with slow increase. In two cases a reduced perfusion and filling were found. There were no statistical differences between the two diagnostic methods (p > 0.01). Conclusion: CHI improves US detections of dermal and subdermal microcirculation in comparison to ICG fluorescence angiography. CHI is a new diagnostic method for postoperative monitoring of free flaps.

Item Type: Article
Uncontrolled Keywords: FREE TISSUE TRANSFER; RECONSTRUCTIVE SURGERY; ENHANCED ULTRASOUND; PERFUSION; DOPPLER; QUANTIFICATION; MODEL; FLOW; ULTRASONOGRAPHY; VASCULARIZATION; parascapular flaps; contrast harmonic ultrasound; fluorescence angiography; microcirculation
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Röntgendiagnostik
Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Plastische-, Hand- und Wiederherstellungschirurgie
Depositing User: Dr. Gernot Deinzer
Date Deposited: 11 Nov 2020 10:41
Last Modified: 11 Nov 2020 10:41
URI: https://pred.uni-regensburg.de/id/eprint/31600

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