The Application Of Color Doppler Ultrasonic Testing Pectoral Branch Of Thoracoacromial Artery Aided Design Pectoralis Major Myocutaneous Flap

Objective: To investigate the clinical significance of preoperative color doppler ultrasonography in the design of pectoralis major muscle flap.Methods:Before the operation,color doppler ultrasonic was applied to detect the pectoral branch of thoracoacromial artery of 26 patients who will be transplanted pectoralis major myocutaneous flap.we detected the starting point of the pectoral branch of thoracoacromial artery,entry point to muscle position and vascular diameter,direction and the hemodynamic parameters.The body surface marker of the pectoral branch of thoracoacromial artery and intraoperative peering into vascular anatomy and ultrasonic testing results were analyzed.Results:1.The hemodynamic parameters of the pectoral branch of thoracoacromial artery on the left:the starting point PSV(29.18?3.93)mm,the starting point EDV(7.41 ? 2.07)mm,entry point to muscle PSV(20.30 ? 2.72)mm,and entry point to muscle EDV(2.39 ? 0.42)mm,RI(0.80 ? 0.03),the hemodynamics parameters of the pectoral of branch of thoracoacromial artery on the right side: the starting point for PSV(30.38? 3.53)mm,the starting point,EDV(7.40? 1.92)mm,entry point to muscle PSV(19.60?2.94)mm,and entry point to muscle EDV(2.30?0.35)mm,RI(0.78?0.03),the pectoral branch of thoracoacromial artery PSV,EDV,RI had no statistical difference(t is 1.430,0.020,1.430,0.859,1.972;P is0.165,0.984,0.381,0.398,0.060).2.The vessel internal diameter of the pectoral branch of thoracoacromial artery on the left:the starting point D(2.20?0.19)mm,entry point to muscleD(1.50?0.25)mm;the vessel internal diameter of the pectoral of branch of thoracoacromial artery on the right side:the starting point D(2.10?0.20)mm,entry point to muscle D(1.50 ? 0.18)mm.The pectoral branch of thoracoacromial artery starting point D and entry point to muscle D had no statistical difference(t is 2.003,0.000;P is 0.056,1.000).In this study,the vessel internal diameter of of 52 pectoral branch of thoracoacromial artery was detected:(1)the starting point D: 1.0-1.5mm: 0(0%,0/52);1.5-2.0mm: 15branches(28.8%,15/52);> 2.0mm: 37(71.2%,37/52).(2)entry point to muscle D: 1.0-1.5mm: 24 branches(46.2%,24/52);1.5mm-2.0mm: 28branches(53.8%,28/52);> 2.0mm: 0(0%,0/52).3.Intraoperative exploration of blood vessel walking and ultrasonic detection of blood vessel were the same is 26 cases(100%,26/26),0 cases(0%,0/26)of non-patients,vascular mutation or absence of patients(0%,0/26).Ultrasonic testing and detection results show that the blood vessels during the left chest muscle branch is located in the body surface marker of the pectoral branch of thoracoacromial artery is 16 cases(61.5%,16/26),located in the inside of the body surface marker of the pectoral branch of thoracoacromial artery within 2 cm is 4 cases(15.4%,4/26),located in the outside of the body surface marker of the pectoral branch of thoracoacromial artery within 2 cm is 6 cases(23.1%,6/26).4.Preoperative CDUS inspecting the pectoral branch of thoracoacromial artery,entry point to muscle and the starting point from clavicle middle respectively are(3.00?0.29)cm,respectively(6.00?0.84)cm.Intraoperative probe the pectoral branch of thoracoacromial artery,entry point to muscle and the starting point from clavicle middle respectively are(2.99 ? 0.33)cm,respectively(5.95?0.82)cm,both are no statistical differences(t were 0.328,1.130;P is 0.746 and 0.269 respectively).Conclusion:Color doppler ultrasound can be simple and accurate detection of entry point to muscle,the starting point,and blood vessels walk of pectoral branch of thoracoacromial artery and provides the vessel internal diameter and bloodflow dynamics parameters,for imaging basis for the design and preparation of pectoralis major myocutaneous flap.