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Objective:To compare the clinical value of CTA and CDU in perforator flap of peroneal artery.Methods:From February 2013 to October 2016, 47 patients who suffered with soft tissue defects and were hospitalised in the Department of Orthopaedics, the 920th Hospital of Joint Logistic Support Force of Chinese PLA were retrospectively reviewed and evaluated. All the defects were reconstructed by the perforator flap of peroneal artery. All patients received preoperative CTA and CDU scans before surgery. Appropriate perforator vessels were selected and the locating points in body surface and external diameters of the perforator vessels were recorded and compared with intraoperative findings. SPSS 22.0 statistical software was used for data analysis. P<0.05 was considered statistically significant. Results:The intraoperative coincidence rate of the proposed perforator vessels was 97.87% for CDU and 95.74% for CTA, with no significant difference between the 2 groups( P>0.05). It was found that the preoperative CTA and CDU measurements were consistent with the actual intraoperative measurements, and there was no significant difference between the 2 groups( P>0.05). For CTA combined with CDU, an intraoperative coincidence rate was 100% in the location of peroneal perforating vessels. All flaps were followed-up for 1 to 18(mean 13.5) months. All the flaps survived well with good texture and appearance without complication. Conclusion:CDU and CTA are reliable and useful in preoperative vascular evaluation of peroneal perforator flap, and both can be used in a complementary or combined manner.
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Objective:To compare the reliability between infrared thermal imaging technology(IRT) and colour Doppler ultrasound (CDU) in the detection of perforators for anterolateral femoral perforator flap(ALTPF).Methods:From September, 2017 to September, 2019, a total of 25 patients(16 males and 9 females, aged 12-53 years old with an average age of 38.7 years old) underwent ALTPF surgery for the purpose of resurfacing and reconstruction. All patients had pedicled or free ALTPF sized from 5.0 cm×8.0 cm to 7.5 cm×30.0 cm. Among all cases, 21 received free flaps and 4 received pedicled flaps. All patients underwent routine IRT and CDU examinations to locate the perforators preoperatively.Results:Of the 25 patients, CDU detected 53 perforators and IRT detected 51 "hot spots". There were 50 "hot spots" that corresponded to the findings of CDU with a κ index at 0.712( P<0.05), representing a high degree of consistency. The sensitivity and specificity were 94.3% and 85.7%, respectively. Conclusion:IRT has a high consistency in detecting perforators for ALTPF in comparison with CDU. IRT features portable, low cost, non-invasive, and easy to operate. At the same time, IRT has advantages in the patients who have thin subcutaneous tissue. With higher accuracy, IRT is expected to become an important part of preoperative perforator navigation.
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So far, evaluation of vertebral arteries has been done by angiography with a limited data on evaluation with duplex scanning of the vertebral arteries. We wanted to study the radiological features and vertebral artery Doppler characteristics, in patients aged above 35 years with a clinical diagnosis of cervical spondylosis. METHODSThis is a case control study with a total of 120 subjects aged over 35 years (60 subjects were cases with the clinical diagnosis of cervical spondylosis and the remaining 60 subjects were age matched controls). Vertebral artery colour Doppler was performed to record peak systolic velocity, time averaged maximum velocity, diameter of the segment in grey scale in millimetres and flow volume of the vertebral artery. Statistical analysis was done using chi square test, student t test and z test with p values < 0.05 being considered statistically significant. RESULTSMajority of patients in both groups were in the age group 41 - 50 years. Among cases 39 (65%) were males and 21 (35%) were females. Most of cases had vertebral artery diameters in the range of 3.0 - 3.5 mm seen both on right [21{35%}] as well as on left side [17 {28.3%}], and a similar finding was observed in controls as well. No statistical significance was observed amongst cases and control on either right or left side. Most of the cases had vertebral artery blood flow in the range of 51-100 mL/min both on right side [26 (43.3%)] and left side [22 (36.7%). On comparing vertebral artery blood flow in the range of ≤100 mL/min and >100 mL/min, the difference was statistically significant on the left side. On comparing the number of cases and controls according to the vertebral artery blood flow velocity ≤30 cm/s and >30 cm/sec on right side, p value was 0.009 and that on the left was 0.001, both of which are statistically significant. CONCLUSIONSVertebral artery diameter is not a very reliable sign in this degenerative condition. Vertebral artery flow volume is decreased at least in one vertebral artery. Vertebral artery blood flow velocity was significantly reduced in cervical spondylosis cases compared to controls both on right side (p=0.009) and left side (p= 0.001). This makes reduced vertebral artery blood flow velocity as a very strong sign in this condition. To conclude vertebral artery ultrasound is a very useful and reliable tool in evaluation of vertebrobasilar insufficiency cases.
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Background: Venous abnormalities of lower limb are a fairly common cause of morbidity. Although clinical diagnosis is the cornerstone of the diagnosis of lower limb venous disease, Colour Doppler ultrasound has become the investigation of choice to confirm the diagnosis. This study evaluated the role of Colour Doppler ultrasound in various venous pathologies of the lower limb and the sonographic findings were correlated with surgical and clinical findings.Methods: 100 patients of all age groups of either sex presenting with clinically suspected entities affecting venous system of the lower limb were selected for this study.Results: Our study showed a definite male preponderance (65%) with an incidence of 41% in the age group of 21-40 years. Isolated varicose veins had an incidence of 58% followed by isolated deep vein thrombosis (DVT) (29%), varicose veins with thrombophlebitis (5%), DVT with thrombophlebitis (5%), DVT with varicose veins (2%) and hematoma (1%). The findings correlated with surgery and gave a sensitivity of 100%.Conclusions: Colour Doppler ultrasound is unique due to its feasibility, accessibility and cost effectiveness. Its dynamism is also exploited by various maneuvers done by the patients, radiologist and the machine parameters to bring about changes in blood flow to reach the exact diagnosis.
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Objective:To investigate the relationshipe and role of front cardiac film,left bariumswallowed film and colour Doppler ultrasound in Inoue balloon dilatation of patients with mitral valve stenosis in rheumatic heart diseas.Methods:The examined results of 136 cases were compared.Results:The signs of mitral valve stenosis in rheumatic heart disease might be observed by the front cardiac film and left barium-swallowed film,and the above-mentioned films could instruct to puncture foramen ovale in Inoue balloon dilatation.Howeuer,it couldn′t evaluate the degree of mitral valve stenosis.There was no relation-shipe between the size of cardiac shadow,left atrial and the narrow degree of mitral valve entrance.The condition of patient ofter operation can be judged by comparing the finding on the pre-and postoperational films,and the size of the mitral valve entrance atrials and ventriculars,and the condition of blood flow can be judged by colour Doppler ultrasound before surgery,so that it can provide reliable data for operation.Conclusion:The combination of both radiography and ultrasound is absolutely necessary in Inoue balloon dilatation of patients with mitral valve stenosis in rheumatic heart disease. [