Prantl, L. and Pfister, K. and Kubale, R. and Schmitt, St. and Stockhammer, V. and Jung, W. and Zorger, N. and Herold, T. and Nerlich, M. and Stehr, A. and Jung, E. M. (2007) Value of high resolution ultrasound and contrast enhanced US pulse inversion imaging for the evaluation of the vascular integrity of free-flap grafts. CLINICAL HEMORHEOLOGY AND MICROCIRCULATION, 36 (3). pp. 203-216. ISSN 1386-0291, 1875-8622
Full text not available from this repository. (Request a copy)Abstract
Objective: The aim of this study was to evaluate the clinical value of color coded Doppler sonography (CCDS) and contrast-enhanced harmonic imaging (CHI) for ultrasound (US) monitoring the integrity of free-flap vascular grafts. Patency of microvascular anastomoses and perfusion as well as microcirculation of the transplanted tissue were analysed. Patients and methods: Fifteen free parascapular flap grafts performed over a period of three years by a single surgeon were examined with CCDS and CHI. The patients (12 male, 3 female) ranged in age from 16 to 60 years (average age 40 +/- 12). The follow-up period ranged from two weeks to 2.5 years. CCDS were performed with a multifrequency linear transducer (5-10 MHz, Logiq 9, GE) with 3D flow detection. For detection and characterization, B scan of the flap tissue was compared to tissue harmonic imaging (THI) and Cross Beam with Speckle Reduction Imaging (SRI). US Pulse Inversion Harmonic Imaging (PIHI) after bolus injection of 2.5 ml Sonovue((R)) was used for contrast enhancement. Results: Border and tissue structure of the flaps could be detected best in all 15/15 cases using Cross Beam Technology with SRI and THI. Correlations were found for flow parameters of the common femoral artery, popliteal artery and lower leg artery to the anastomotic vessels. 3D imaging with CCDS facilitated flow detection of elongated and small anastomotic vessels in 4/15 cases. Contrast-enhanced US with PIHI allowed dynamic flow detection of the microcirculation of the transplanted tissue over a depth of up to 3 cm with quantitative perfusion curves of the tissue microcirculation. Reduced US contrast enhancement with modified perfusion curves was seen in 2/15 cases with low anastomic flow in CCDS. Conclusion: Assessment of microvascular perfusion with contrast-enhanced ultrasound can provide valuable information on free flap viability. Contrast-enhanced US enables dynamic and quantitative flow detection of free flap tissue.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | FREE TISSUE TRANSFER; RECONSTRUCTIVE SURGERY; PERFUSION; DOPPLER; QUANTIFICATION; FLOW; ULTRASONOGRAPHY; PLETHYSMOGRAPHY; MICROSURGERY; METASTASES; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Gefäßchirurgie Medicine > Lehrstuhl für Röntgendiagnostik Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Plastische-, Hand- und Wiederherstellungschirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 11 Jan 2021 13:17 |
| Last Modified: | 11 Jan 2021 13:17 |
| URI: | https://pred.uni-regensburg.de/id/eprint/33380 |
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