Recent Advances in Ultrasound Technology: Ultra-High Frequency Ultrasound for Reconstructive Supermicrosurgery

Abstract

Background Currently, microsurgeons are in the era of supermicrosurgery and perforator flap reconstruction. As these reconstructions frequently utilize vessels that are smaller than a single millimeter, understanding of location of lymphatic vessels and perforator anatomy preoperatively is essential. To change with the times, the role of ultrasound has changed from just an adjunct to primary imaging of the choice in reconstructive supermicrosurgery. Recently, a novel ultrasonographic technique involving the use of ultra-high frequency ultrasound (UHFUS) frequencies has entered the scene, and appears a promising tool in surgical planning.

Methods The literatures on the applications of UHFUS in reconstructive supermicrosurgery were retrieved and reviewed from more than 60 literatures have been published on the surgical applications of UHFUS.

Results Nine studies were retrieved from the literature on the applications of UHFUS in reconstructive supermicrosurgery. The articles report both application for lymphatic surgery and perforator flaps.

Conclusion UHFUS application involves an increasing number of reconstructive supermicrosurgery field. UHFUS is a valuable and powerful tool for any reconstructive surgeons who are interested in performing supermicrosurgery.

Keywords

ultra-high frequency - ultrasound - supermicrosurgery - lymphedema - LVA - reconstructive microsurgery - perforator flap

Publication History

Received: 01 June 2021

Accepted: 26 September 2021

Article published online:
17 December 2021

• References

• 1 Wortsman X. Ultrasound in dermatology: why, how, and when?. Semin Ultrasound CT MR 2013; 34 (03) 177-195
• 2 Schmid-Wendtner MH, Dill-Müller D. Ultrasound technology in dermatology. Semin Cutan Med Surg 2008; 27 (01) 44-51
• 3 Badash I, Gould DJ, Patel KM. Supermicrosurgery: history, applications, training and the future. Front Surg 2018; 5: 23
• 4 Oni G, Chow W, Ramakrishnan V, Griffiths M. Plastic surgeon-led ultrasound. Plast Reconstr Surg 2018; 141 (02) 300e-309e
• 5 Cho MJ, Kwon JG, Pak CJ, Suh HP, Hong JP. The role of duplex ultrasound in microsurgical reconstruction: review and technical considerations. J Reconstr Microsurg 2020; 36 (07) 514-521
• 6 Izzetti R, Vitali S, Aringhieri G. et al. Ultra-high frequency ultrasound, a promising diagnostic technique: review of the literature and single-center experience. Can Assoc Radiol J 2021; 72 (03) 418-431
• 7 Gan LM, Grönros J, Hägg U. et al. Non-invasive real-time imaging of atherosclerosis in mice using ultrasound biomicroscopy. Atherosclerosis 2007; 190 (02) 313-320
• 8 Lavaud J, Henry M, Coll JL, Josserand V. Exploration of melanoma metastases in mice brains using endogenous contrast photoacoustic imaging. Int J Pharm 2017; 532 (02) 704-709
• 9 Carotenuto AR, Cutolo A, Petrillo A. et al. Growth and in vivo stresses traced through tumor mechanics enriched with predator-prey cells dynamics. J Mech Behav Biomed Mater 2018; 86: 55-70
• 10 Fernandes DA, Kolios MC. Intrinsically absorbing photoacoustic and ultrasound contrast agents for cancer therapy and imaging. Nanotechnology 2018; 29 (50) 505103
• 11 Hayashi A, Visconti G, Yamamoto T. et al. Intraoperative imaging of lymphatic vessel using ultra high-frequency ultrasound. J Plast Reconstr Aesthet Surg 2018; 71 (05) 778-780
• 12 Visconti G, Hayashi A, Yoshimatsu H, Bianchi A, Salgarello M. Ultra-high frequency ultrasound in planning capillary perforator flaps: preliminary experience. J Plast Reconstr Aesthet Surg 2018; 71 (08) 1146-1152
• 13 Hayashi A, Giacalone G, Yamamoto T. et al. Ultra high-frequency ultrasonographic imaging with 70 MHz scanner for visualization of the lymphatic vessels. Plast Reconstr Surg Glob Open 2019; 7 (01) e2086
• 14 Visconti G, Bianchi A, Hayashi A, Salgarello M. Pure skin perforator flap direct elevation above the subdermal plane using preoperative ultra-high frequency ultrasound planning: a proof of concept. J Plast Reconstr Aesthet Surg 2019; 72 (10) 1700-1738
• 15 Yoshimatsu H, Hayashi A, Yamamoto T. et al. Visualization of the “Intradermal Plexus” using ultrasonography in the dermis flap: a step beyond perforator flaps. Plast Reconstr Surg Glob Open 2019; 7 (11) e2411
• 16 Visconti G, Bianchi A, Hayashi A. et al. Thin and superthin perforator flap elevation based on preoperative planning with ultrahigh-frequency ultrasound. Arch Plast Surg 2020; 47 (04) 365-370
• 17 Bianchi A, Visconti G, Hayashi A, Santoro A, Longo V, Salgarello M. Ultra-high frequency ultrasound imaging of lymphatic channels correlates with their histological features: a step forward in lymphatic surgery. J Plast Reconstr Aesthet Surg 2020; 73 (09) 1622-1629
• 18 Visconti G, Bianchi A, Hayashi A, Salgarello M. Ultra-high frequency ultrasound preoperative planning of the rerouting method for lymphaticovenular anastomosis in incisions devoid of vein. Microsurgery 2020; 40 (06) 717-718
• 19 Yoshimatsu H, Karakawa R, Fuse Y, Okada A, Hayashi A, Yano T. Use of preoperative high-resolution ultrasound system to facilitate elevation of the superficial circumflex iliac artery perforator flap. J Reconstr Microsurg 2021; 37 (09) 735-743 Online ahead of print.
• 20 Yamamoto T, Narushima M, Doi K. et al. Characteristic indocyanine green lymphography findings in lower extremity lymphedema: the generation of a novel lymphedema severity staging system using dermal backflow patterns. Plast Reconstr Surg 2011; 127 (05) 1979-1986
• 21 Yamamoto T, Matsuda N, Doi K. et al. The earliest finding of indocyanine green lymphography in asymptomatic limbs of lower extremity lymphedema patients secondary to cancer treatment: the modified dermal backflow stage and concept of subclinical lymphedema. Plast Reconstr Surg 2011; 128 (04) 314e-321e
• 22 Yamamoto T, Yamamoto N, Doi K. et al. Indocyanine green-enhanced lymphography for upper extremity lymphedema: a novel severity staging system using dermal backflow patterns. Plast Reconstr Surg 2011; 128 (04) 941-947
• 23 Hayashi A, Yamamoto T, Yoshimatsu H. et al. Ultrasound visualization of the lymphatic vessels in the lower leg. Microsurgery 2016; 36 (05) 397-401
• 24 Hayashi A, Hayashi N, Yoshimatsu H, Yamamoto T. Effective and efficient lymphaticovenular anastomosis using preoperative ultrasound detection technique of lymphatic vessels in lower extremity lymphedema. J Surg Oncol 2018; 117 (02) 290-298
• 25 Hong JP, Choi DH, Suh H. et al. A new plane of elevation: the superficial fascial plane for perforator flap elevation. J Reconstr Microsurg 2014; 30 (07) 491-496