数字化三维重建技术在股前外侧皮瓣血供及其可视化中的应用

Three-dimensional reconstructive methods used in the visualization of anterolateral thigh flaps

目的探讨数字化三维重建技术在股前外侧皮瓣血供与可视化中的应用。方法①健康志愿者6人经肘正中静脉注射造影剂，使用64排多层螺旋CT进行盆腔及双下肢扫描，观察旋股外侧动脉分布及彼此间的吻合情况，将大腿二维灰度．DICOM格式图像以三维体数据的形式输入计算机，应用Amira3．1软件对股前外侧皮瓣结构进行三维重建并立体显示。②明胶一氧化铅混悬液的灌注新鲜成人标本2具，16排多层螺旋CT进行全身连续扫描，观测旋股外侧动脉分布及彼此间的吻合情况，同法应用Amira3.1软件对股前外侧皮瓣结构进行三维重建并立体显示。结果重建的数字化模型可准确反映股前外侧皮瓣血供的解剖学结构。结论采用数字化三维重建技术可以提供正常股前外侧皮瓣的三维动态解剖，为其他皮瓣的数字化重建提供了参考。

Objective To discuss the digitalization technique used in the visualization of anterolateral thigh （ATL） flaps and their blood supply. Methods Six adult volunteers underwent contrast-enhanced CT angiography of pelvic and lower limbs using a 64-row multi-slice spiral CT after injection with Uhravist （3. 5 mL/s） through the median cubital vein. The 2D images from the scanning in DICOM format were transformed into three-dimensional data by computer. Next, 2 specimens of adult fresh cadaver, one male and one female, were subject to radiographic CT scanning before and after perfusion with lead oxide-gelatine mixture, with collimation of 0. 5 mm （120 kV, 110 mA, 512×512 matrix）. Amira 3. 1 （TGS） software was used to transform the 2D images in DICOM format into 3D models of the entire region. The structures of arteria circumflexa femoris lateralis （ACFL） were observed and the digitized visible models of ALT flap were established through three-dimensional computerized reconstruction out of these data using Amira 3.1 software. Results The three-dimensional reconstruction of visible models established from these datasets perfectly displayed the characteristics of ALT flap anatomy. Conclusion The digitized images can offer unique insights into the ALT flap anatomy and the reconstruction methods may be used in 3D demonstration of other flaps.