基于Micro-CT血管成像技术重建大鼠先天性尿道下裂包皮血管的实验研究  

Three-dimensional reconstruction of preputial vessels in a rat model of congenital hypospadias

作　　者：林德富[1] 宋宏程[1] 刘沛 王冠男[1] 梁海燕[1] 张潍平[1] 孙宁[1] Lin Defu;Song Hongcheng;Liu Pei;Wang Guannan;Liang Haiyan;Zhang Weiping;Sun Ning(National Center for Children's Health,Department of Urology,Beijing Children's Hospital,Capital Medical University,Beijing 100045,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院泌尿外科,100045

出　　处：《中华小儿外科杂志》2020年第5期462-467,共6页Chinese Journal of Pediatric Surgery

基　　金：中国国家重点研发计划(2016YFC1000807)。

摘　　要：目的应用Micro-CT扫描技术分析尿道下裂大鼠包皮血管的分布规律,阐述不同类型尿道下裂血管的分布特点,为尿道下裂皮瓣的选择提供理论基础。方法选取孕鼠6只,应用非那雄胺溶液(40 mg·kg^-1·d^-1)于孕12~17 d连续6 d经腹部皮下注射,分娩28 d后对幼鼠进行计数,根据幼鼠尿道外口位置分为正常组和轻度、重度尿道下裂组。幼鼠6个月龄时于腹主动脉插管并行硅酮橡胶(Microfil)灌注后行Micro-CT扫描,CTAn软件收集扫描数据后对整个阴茎组织行三维重建,得到完整包皮血管影像,观察不同程度尿道下裂包皮血管的分布特点并计算包皮血管分数。结果共产幼鼠41只,雄性24只,阴茎正常的有8只,尿道下裂的有16只,轻度尿道下裂的有3只,重度尿道下裂的有13只。Micro-CT扫描包皮血管情况:①正常组及轻度下裂组,二者包皮血管形态相似,两侧阴茎背浅动脉的深层血管分别走行于阴茎体的背外侧,于包皮内外板交界处形成环绕阴茎头的血管环结构后向内板发出细小分支;②重度下裂组,根据血管形态分为血供良好(6只)和血供不良(7只)两种类型,血供良好型内外板交界处可形成类似正常组和轻度尿道下裂组的血管环;血供不良型则不能形成血管环结构,其血管分支不发达,部分血管呈网状分布。结论大鼠孕期应用非那雄胺可产生稳定尿道下裂后代。包皮内外板交界处血运丰富,适合作尿道皮瓣材料;内外板交界处的血管环结构与横裁岛状皮瓣法裁剪方向一致,最大程度地保存了皮瓣血运。包皮血供不良的重度尿道下裂内外板的血管环结构消失,而管径细小的网状血管增多,这可能是重度尿道下裂患者术后并发症发生率较高的原因之一。Objective To employ micro-CT to reconstruct and analyze preputial vessels in a finasteride-induced rat model of congenital hypospadias.Methods Pregnant rats were exposed to finasteride at embryonic day 12 to 17.According to the position of urethral meatus,the fetuses were divided into normal,mild hypospadias and severe hypospadias groups.At 6 months after birth,preputial blood vessels were observed by vascular perfusion with Microfil(a silicone-based polymer)and scanned by Micro-CT.The scanning data were stored and reconstructed three-dimensionally by CTvox.A pathological analysis of specimen was performed to determine the position of Microfil.Results The anatomy of penile and preputial dartos vessels,dorsal penile vessels,corpora cavernosa and corpus spongiosum were visualized distinctly through micro-CT imaging.Normal and mild hypospadias groups had similar preputial morphologies.The deep layer of penile dartos artery followed phallus by dorsolateral position.The junction of inner and outer prepuce had a rich supply of blood vessels in a ring-like structure.Severe hypospadias group was further assigned into good blood supply type(n=5)and insufficient blood supply type(n=6).In good blood supply type,ring-like vessels were also found at the junction of inner and outer prepuce.Yet there was only a small amount of capillary supply in insufficient type.Conclusions As compared to traditional techniques,micro-CT can improve our understanding of hypospadias preputial vascular structure in three dimensions.The junction of inner and outer prepuce with a rich blood supply is suitable as a vascular pedicle.

关 键 词：包皮 血管 尿道下裂 大鼠 模型 动物 

分 类 号：R726.9[医药卫生—儿科]