Comparison of Single Photon Emission Computed Tomography (SPECT) and implantable Doppler in the monitoring of a vascularised fibular free flap for reconstruction of the mandible.
Research article published in The British journal of oral & maxillofacial surgery (2020)
Abstract
Monitoring of microvascular free flaps is an influencing factor in the success or failure of the treatment. In this study, we aim to compare the accuracy of implantable Doppler and scintigraphy in the monitoring of a vascularised buried fibular graft for reconstruction of the mandible. In a prospective cohort study, an implantable Doppler was placed intraoperatively, and Single Photon Emission Computed Tomography (SPECT) was taken in patients when abnormal blood flow was detected via the implantable Doppler or 48 hours after operations in patients with normal signals on the Doppler. The flaps were explored if patients did not have regular signals via implantable Doppler or if SPECT revealed impaired perfusion. The number of true- and false-positive cases and true- and false-negative cases were documented. Positive predictive value (PPV) and negative predictive value (NPV) were calculated. Eighteen (29%) of 62 patients underwent explorative surgery. The sensitivity of SPECT was 38.88%, and specificity was 97.72%. In SPECT, PPV was 87.50% and NPV 79.62%. The sensitivity of the implantable Doppler was 72.22%, and specificity was 93.08%. In assessment with the implantable Doppler, PPV was 81.25% and NPV 93.18%. It seems that SPECT and the implantable Doppler had sufficient specificity in the monitoring of a buried fibular graft. However, SPECT had a lower sensitivity than the implantable Doppler.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Monitoring of microvascular free flaps is an influencing factor in the success or failure of the treatment. In this study, we aim to compare the accuracy of implantable Doppler and scintigraphy in the monitoring of a vascularised buried fibular graft for reconstruction of the mandible.
Por qué esto importa para la hirudoterapia
Este estudio prospectivo de cohorte comparó la exactitud diagnóstica del Doppler implantable frente a las imágenes SPECT para la monitorización de colgajos libres vascularizados de peroné en reconstrucción mandibular, inscribiendo a 62 pacientes y reportando que el Doppler implantable presentó una mayor sensibilidad (72,22 % vs. 38,88 %), mientras que ambas modalidades mostraron una alta especificidad. La relevancia con el ámbito de la ASH es indirecta: si bien la hirudoterapia puede utilizarse para el rescate de la congestión venosa en colgajos libres, este artículo no menciona sanguijuelas, hirudoterapia ni sustancias derivadas de sanguijuelas. El estudio se centra exclusivamente en tecnologías de monitorización de la perfusión postoperatoria del colgajo. Ningún dato del resumen conecta con la hirudoterapia más allá del escenario clínico compartido de la cirugía reconstructiva microvascular, donde las sanguijuelas pueden constituir una intervención adyuvante entre muchas otras.
Citación
Comparison of Single Photon Emission Computed Tomography (SPECT) and implantable Doppler in the monitoring of a vascularised fibular free flap for reconstruction of the mandible.
Tabrizi et al. · The British journal of oral & maxillofacial surgery, 2020
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: 18 de junio de 2026