中国临床解剖学杂志 ›› 2011, Vol. 29 ›› Issue (3): 243-248.

• 应用解剖 • 上一篇    下一篇

数字化前臂穿支皮瓣模型构建与解剖学研究

留成胜, 黄潮桐, 陈隆福, 李敬矿, 陈冬生   

  1. 广东医学院附属厚街医院,  广东   东莞    523945
  • 收稿日期:2010-11-20 出版日期:2011-05-25 发布日期:2011-05-21
  • 通讯作者: 黄潮桐,教授、主任医师,研究生导师,Tel:13922907328 E-mail:andy_ lcs8 @126.com
  • 作者简介:留成胜(1983-),男,浙江衢州市人,骨外科硕士研究生,研究方向:数字医学在骨科的应用,Tel:15015165077

Digital arterial perforator flap in forearm: anatomy and reconstruction

LIU Cheng-sheng, HUANG Chao-tong, CHEN Long-fu, LI Jing-kuang, CHEN Dong-sheng   

  1. Affiliated Houjie Hospital of Guangdong Medical College, Dongguan 523945, Guangdong, China
  • Received:2010-11-20 Online:2011-05-25 Published:2011-05-21

摘要:

目的 利用计算机三维重建技术构建前臂数字化模型,探讨前臂动脉穿支特点,虚拟仿真临床个性化皮瓣设计。  方法 选用新鲜男尸体无器质性损伤前臂标本4只,常温下灌注显影剂,经CT扫描后,将数据导入医学图像处理软件Mimics13.1中,分别对骨骼、血管及软组织进行三维构建。测量前臂穿支血管数目、蒂长、管径,距尺、桡骨茎突距离,为穿支皮瓣切取提供依据。根据穿支血管支配区域,对图像进行多次分割,构建数字化穿支皮瓣。  结果 数字化前臂三维构建的图像仿真高,可立体显示前臂各穿支血管及其穿支皮瓣。桡动脉、尺动脉、骨间后动脉穿支血管数是12~17、10~15、5~11支,与实体解剖学数据基本一致。  结论 通过构建数字化前臂模型,测量数据表明各标本动脉起源、行程及其穿支较恒定,可根据尺桡动脉及骨间后动脉穿支血管的分布情况,设计皮瓣的范围,对临床穿支皮瓣的切取具有较重要的意义。

关键词: 数字医学, 前臂, 穿支血管, 穿支皮瓣, 三维构建

Abstract:

Objective To provide a three-dimensional (3D) model that reveals detailed architecture of the perforators in the forearm that enables secure elevation of the personal perforator flap for clinic. Methods Four adult male fresh forearms underwent lead oxide-latex injection. Spiral computed tomographic scanning was then performed and three-dimensional reconstructions were finished using Mimics 13.1. Specimens were then dissected by layers to document the individual perforators. We had accurately measured the number, length, diameter and distance from the ulnar and radial styloid process of perforators by way of providing evidence in support of flaps. Based on perforator region, we had got digital perforator flaps by segmentation of images.    Results    3D reconstructed visualization images could perfectly display the arteries, their perforator and perforator flaps in forearm. The number of radial, ulnar, and posterior interosseous artery perforators were 12~17, 10~15, 5~11 respectively. Conclusions As result of origin, course and branches of perforator flaps were constant by way of the study of reconstructed 3D images and measurement data. According to the distribution of perforating posterior interosseous artery, radial and ulnar arteries, we had designed the area of perforator flap. The study could guide operative design and operative procedure.

Key words: Digital medicine, Forearm, Perforator artery, Perforator flaps, 3D reconstruction

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