Reliability of Near-Infrared Angiography and Micro-Doppler Sonography for Evaluating Microvascular Anastomoses
Reliability of Near-Infrared Angiography and Micro-Doppler Sonography for Evaluating Microvascular Anastomoses
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DOI：
10.1097/prs.0b013e3181f0215a
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发表时间：
2010-11-01
影响因子：
3.6
通讯作者：
Scholz, Martin
中科院分区：
文献类型：
--
作者：
Muecke, Thomas;Wolff, Klaus-Dietrich;Scholz, Martin
背景：术中荧光血管造影术被报道为一种有前景的方法，用于微血管并发症的检测具有快速、高质量、低成本的优点。本研究的目的是评估术中近红外吲哚青绿血管造影与微血管多普勒检测在不同血管通畅大鼠标准化模型中的可靠性。方法：使用23只Wistar大鼠的颈动脉、主动脉和股动脉。应用吲哚青绿血管造影术和微血管多普勒超声检查评价微血管吻合，吻合口血管通畅率分别为100%、75%、50%、25%和0%。结果：共对68个吻合口进行了424次检查，包括吲哚青绿视频血管造影和微血管多普勒超声检查。微血管多普勒超声检测不同程度狭窄的敏感性和特异性分别为100%和86.9%。所有观察的阳性预测值为95.8%，相应的阴性预测值为100%。吲哚青绿血管造影术的总体敏感性为95.3%，特异性为100%。阳性预测值为100%，阴性预测值为84%。结论：吲哚青绿血管造影术和微血管多普勒超声是实验室模型中快速、可靠的血管血流评价方法。吲哚青绿血管造影与微血管多普勒超声联合应用可提高术中微血管吻合口评估的准确性。可以首先使用吲哚青绿，但在结果为阴性的情况下，随后进行微血管多普勒检查，以最大限度地提高准确性。(最后一次。重新构造外科126：1506,2010。)
Background: Intraoperative fluorescence angiography has been reported to be a promising method, with rapid and high-quality image production at low cost when used for the detection of microvascular complications. The purpose of this study was to evaluate the reliability of intraoperative near-infrared indocyanine green angiography compared with microvascular Doppler testing in a standardized model in the rat with different vessel patencies.Methods: The carotid, aorta, and femoral vessels of 23 Wistar rats were used. Indocyanine green angiography and microvascular Doppler sonographic testing were performed to assess microanastomosis with a vessel patency randomly narrowed at the anastomosis to an outer patency of 100, 75, 50, 25, and 0 percent.Results: A total of 424 investigations were performed for 68 anastomoses, including both indocyanine green videoangiographic and microvascular Doppler sonographic examinations. The overall sensitivity and specificity of the microvascular Doppler sonographic testing at different degrees of stenoses were 100 and 86.9 percent, respectively. The positive predictive value for all observations was 95.8 percent, and the corresponding negative predictive value was 100 percent. Indocyanine green angiography revealed an overall sensitivity of 95.3 percent and a specificity of 100 percent. The positive predictive value for these observations was 100 percent, and the negative predictive value was 84 percent.Conclusions: Indocyanine green angiography and microvascular Doppler sonography are quick and reliable methods for assessing blood flow in vessels in the laboratory model. The combined use of indocyanine green angiography and microvascular Doppler sonography can increase the accuracy of assessment of microvascular anastomoses intraoperatively. Indocyanine green can be used first, but followed by the microvascular Doppler in cases of a negative result to maximize accuracy. (Plast. Reconstr. Surg. 126: 1506, 2010.)