CT血管造影及可视化研究在背阔肌肌皮瓣移植中的临床应用  

APPLICATION OF COMPUTED TOMOGRAPHY ANGIOGRAPHY IN VISUALIZE OF LATISSIMUS DORSI MYOCUTANEOUS FLAP TRANSPLANTATION

作　　者：陆声[1] 徐永清[1] 张元智[2] 李军[1] 严睿[1] 陈玉兵[1] 郭海[1] 孙林辉[1] 

机构地区：[1]成都军区昆明总医院全军骨科中心,昆明650032 [2]内蒙古医学院附属医院骨科

出　　处：《中国修复重建外科杂志》2009年第7期818-821,共4页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家博士后基金资助项目(20080431420)~~

摘　　要：目的探讨CT血管造影(computed tomography angiography,CTA)技术用于背阔肌肌皮瓣(latissimus dorsi myocutaneous flap,LDM)移植的可行性及临床意义。方法2007年9月-2008年8月,收治3例四肢大面积皮肤肌肉缺损需行LDM移植的患者。男2例,女1例;年龄23～42岁。均为外伤后皮肤缺损;其中前臂2例,小腿1例,范围17cm×8cm～20cm×10cm。采用CTA观测胸背动脉分布及彼此吻合情况,计算机三维重建并立体显示LDM结构,根据结果进行术前设计。结果三维重建技术可准确反映LDM的解剖学结构特点。术中见3例患者血管走行、分布与术前设计一致,LDM均顺利切取,切取范围19cm×10cm～22cm×12cm。3例均获随访,随访时间4～12个月。皮瓣质地、色泽良好。结论重建的图像可提供正常LDM三维动态解剖,为临床术前LDM设计提供直观的数字化解剖依据。Objective To evaluate the feasibility and clinical significance of the computed tomography angiography （CTA） for the latissimus dorsi muscle （LDM） flap transplantation. Methods From September 2007 to August 2008, 3 cases of soft tissue defects in limbs were treated with LDM flap transplantation. Three patients included 2 males and 1 female who were 23 to 42 years old. All of soft tissue defects were caused by trauma. The locations were the forearm in 2 cases and the leg in 1 case. The area of defect was 17 cm × 8 cm-20 cm × 10 cm. All cases received CTA to observe the distribution and anastomosis of thoracodorsal artery. Subsequently, three-dimensional computer reconstruction were carried out to display the stereoscopic structure of the LDM flap and to design the LDM flap before operation. Results The anatomy characteristic of LDM flap can be displayed accurately by the three-dimensional reconstruction model. The distribution of thoracodorsal artery in 3 cases of flaps was in concordance with preoperative design completely. All the flaps were excised successfully, the area of the flap was 19 cm × 10 cm-22 cm × 12 cm. All the transferred flaps survived completely. All cases were followed up from 4 months to 12 months. The color and texture of the flaps were good. Conclusion The three-dimensional reconstructive images can provide visible, stereoscopic and dynamic anatomy for clinical application of LDM flap. The digitized three-dimensional reconstructive models of LDM flap structures can be applied in clinical training and pre-onerative design.

关 键 词：背阔肌肌皮瓣 CT血管造影术 计算机辅助 三维重建 

分 类 号：R658[医药卫生—外科学]