穿支形态学的层次解剖与3D定位  

Hierarchical anatomy and 3D localization of perforator branch morphology

作　　者：周小兵 张兴 姚婕 王潜 熊振华 丁茂超 Zhou Xiaobing;Zhang Xing;Yao Jie;Wang Qian;Xiong Zhenghua;Ding Maochao(Experimental Center of Human Morphology,Heng-yang Medical College,University of South China,Hengyang 421001,Hunan Province,China;Department of Hand Microsurgery,Zhanhe Orthopedics and Traumatology Hospital,Pingdingshan 467000,Henan Province,China;Department of Human Anatomy,School of Basic Medicine,Wenzhou Medical University,Wenzhou 325035,Zhengjiang Province,China)

机构地区：[1]南华大学衡阳医学院人体形态实验中心,湖南衡阳421001 [2]平顶山市湛河骨伤科医院手显微外科,河南平顶山467000 [3]温州医科大学基础医学院人体解剖学教研室,浙江温州325035

出　　处：《中国临床解剖学杂志》2024年第5期575-580,共6页Chinese Journal of Clinical Anatomy

摘　　要：目的基于数字解剖学技术构建穿支血管层次解剖及定位的标准方法,为穿支血管的形态学研究提供参考。方法新鲜成人标本5具,行全身动脉灌注,2具用红色乳胶-羧甲基纤维素混悬液灌注,另外3具用氧化铅-红色乳胶-羧甲基纤维素混悬液灌注。前者供大体层次解剖,后者进行多排螺旋CT扫描,应用图像工作站(Mimics,Materialise,Belgium)先行数字解剖,建立皮瓣数字解剖模型,然后大体层次解剖。结果标本的血管填充良好,边缘连续平滑,无空泡产生及中断现象。真皮下血管网,皮神经及其营养血管链清晰可见。三维图像的血管主干及大、小分支均饱满清晰,无齿状伪影,立体感强。结论①碱化、温控与混悬剂配比为数字化前期处理的三要素;②应用Mimics建立的皮瓣数字解剖模型,可对穿支进行精准的层次解剖与3D追踪定位。Objective To construct a standard method of hierarchical anatomy and localization of perforating vessels based on digital anatomy technology,so as to provide reference for morphological research of perforating vessels.Methods Five donated adult fresh specimens were performed via systemic arterial:two of them with red latex-carboxymethyl cellulose suspension and the left three with lead oxide-red latexcarboxymethyl cellulose suspension.After specimen perfusion,the former was used for gross level anatomy,while the latter was scanned by multiple row spiral CT(MDCT),and then the image workstation(MIMICS,Materialise,Belgium)was used to establish a digital anatomical model of the flap,followed by gross hierarchical dissection.Results The blood vessels of the specimen are well filled,with continuous and smooth edges,and no cavitation or interruption.The subdermal vascular network,cutaneous nerves and their nutrient vascular chains were clearly visible.The main trunk of blood vessels,large and small branches of the three-dimensional image were clear,with stunning 3D effect and without tooth-like artifacts.Conclusions①The three elements of digital early treatment are alkalization,temperature control and suspension ratio.②The digital anatomical model of the flap established by Mimics can provide precise hierarchical anatomy and 3D tracking and positioning of the perforator.

关 键 词：穿支皮瓣 血管造影 数字解剖 MIMICS 3D导航定位 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学] R814.42[医药卫生—基础医学]