Abstract：
Preoperative selection of perforator is one of the key steps for successful surgery. The purpose of this study is to simulate the selection process of the perforator of the flap using the 3D models of the deep inferior epigastric artery (DIEA). A retrospective study was performed of women who underwent deep inferior epigastric perforator flap breast reconstruction from January 2011 to July 2021. Construct 3D models of the DIEA using computerized tomography angiography images, and then computational fluid dynamics simulations were performed. Correlation and regression analyses were used to analyze the geometric and hemodynamic parameters. Statistical analysis suggested that the outlet flow was positively correlated with the inlet area (r = 0.338, p = 0.000), outlet area (r = 0.840, p = 0.000), the average radius of the perforator (r = 0.592, p = 0.000), and negatively correlated with the length of perforator(r = -0.210, p = 0.024). The results of linear regression analysis showed that the outlet area (p = 0.000), the average radius (p = 0.000), and the length (p = 0.044) of the perforator were the influencing factors on outlet flow. In multiple perforators analysis, there was a significant difference in the total outlet flow among single perforator, double perforators, and triple perforators (p = 0.002). The successful implementation of this experiment provides a new approach for the selection of dominant perforators in the future.
摘要：
术前选择穿支器是手术成功的关键步骤之一。这项研究的目的是使用深腹下动脉（DIEA）的3D模型来模拟皮瓣穿支的选择过程。对2011年1月至2021年7月接受深下腹穿支皮瓣乳房重建的妇女进行了回顾性研究。使用计算机断层扫描血管造影图像构建DIEA的3D模型，然后进行了计算流体力学模拟。使用相关和回归分析来分析几何和血液动力学参数。统计分析表明出口流量与入口面积呈正相关(r=0.338,p=0.000)。出口面积（r=0.840，p=0.000），射孔器的平均半径(r=0.592,p=0.000),与穿孔器长度呈负相关(r=-0.210,p=0.024)。线性回归分析结果表明,出口面积(p=0.000),平均半径(p=0.000)，射孔器的长度（p=0.044）是影响出口流量的因素。在多个射孔器分析中，单个射孔器的总出口流量存在显着差异，双穿孔器,和三射孔器（p=0.002）。该实验的成功实施为今后优势射孔器的选择提供了新的途径。
